EDI Technical Analyst (Claims) - Hybrid

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    "location": {
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      "state": "Arizona",
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    "datePosted": "2026-06-04",
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    "description": "<p><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\"><span style=\"font-weight: bold\">Location</span>: The position is a Hybrid role at least once a week in Phoenix, AZ 85021</span></span><br><br><span style=\"font-size: 12pt; font-weight: bold\"><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Description:</span></span></span><br><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">The EDI Technical Analyst (Claims) is responsible for supporting, analyzing, testing, and maintaining EDI transactions, integrations, and data exchange processes that support healthcare claims operations. This role partners with business and technical teams to troubleshoot production issues, develop technical documentation, create data mappings, support testing efforts, and ensure the successful exchange of healthcare data between trading partners. The ideal candidate combines strong analytical skills, EDI expertise, SQL proficiency, healthcare systems knowledge, and experience supporting payer platforms such as QNXT to drive operational efficiency and data integrity.</span></span></p>\n<p><span style=\"font-size: 12pt\"><span style=\"font-weight: bold\"><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">What You Will Do:</span></span></span></span></p>\n<ul>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Support, troubleshoot, and resolve EDI production issues related to claims and trading partner transactions.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Analyze, map, and validate healthcare data exchanges including 270/271, 834, 835, and 837 transactions.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Develop technical specifications, mapping documents, process flows, and operational procedures.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Write and maintain SQL queries for production support, reporting, testing, and data validation.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Perform root cause analysis and collaborate with internal teams to resolve data and integration issues.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Create and execute test plans, process test files, document results, and support defect resolution activities.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Utilize tools such as Splunk, App Insights, SOAP UI, and Postman to monitor, troubleshoot, and validate system performance.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Support API integrations, ETL processes, and enterprise data exchange initiatives.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Develop dashboards, reports, and monitoring solutions to ensure data quality and transaction integrity.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Participate in project planning, implementation activities, and continuous process improvement initiatives.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Maintain compliance with HIPAA requirements and healthcare EDI standards including TR3, CAQH CORE, and Blue Exchange guidelines.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Participate in on-call support rotations and production incident response activities.</span></span></li>\n</ul>\n<p><span style=\"font-size: 12pt\"><span style=\"font-weight: bold\"><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You Will Be Successful If:</span></span></span></span></p>\n<ul>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You have hands-on experience supporting QNXT, healthcare claims processing, and EDI transaction workflows within a payer environment.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You have experience supporting healthcare EDI transactions and claims-related data exchanges.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You can quickly identify, troubleshoot, and resolve complex data and integration issues.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You possess strong SQL and data analysis skills and can confidently work with large datasets.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You effectively translate business requirements into technical solutions and documentation.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You are comfortable working across multiple systems, integrations, and business stakeholders.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You thrive in a fast-paced environment with competing priorities and deadlines.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You proactively identify opportunities to improve operational processes, monitoring, and reporting.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You demonstrate strong communication skills and can explain technical concepts to both technical and non-technical audiences.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">You are committed to delivering high-quality solutions that improve customer and business outcomes.</span></span></li>\n</ul>\n<p><span style=\"font-size: 12pt\"><span style=\"font-weight: bold\"><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">What You Will Bring:</span></span></span></span></p>\n<ul>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">High School Diploma or GED required; Bachelor's degree in Computer Science, Information Systems, Business, or related field preferred.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">2+ years of EDI experience supporting healthcare transactions.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Experience working with healthcare claims, enrollment, eligibility, or payment transactions (270/271, 834, 835, and 837 preferred).</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Strong experience with QNXT is highly preferred.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Experience supporting healthcare payer environments, claims processing systems, and trading partner integrations.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Experience in data analysis, data management, integration, and reporting.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Strong SQL query development and database analysis skills.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Knowledge of healthcare EDI standards, HIPAA regulations, and data mapping methodologies.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Experience with testing tools such as SOAP UI and Postman.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Familiarity with monitoring and logging tools such as Splunk and App Insights.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Understanding of API integrations, ETL processes, cloud platforms (AWS, Azure), and enterprise application environments.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Knowledge of Edifecs EDI platform is a plus.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Excellent analytical, troubleshooting, technical documentation, and problem-solving skills.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Ability to manage multiple priorities while working independently and collaboratively across teams.</span></span></li>\n<li><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-weight: inherit\">Strong communication skills with the ability to translate technical concepts for business and operational stakeholders.</span></span></li>\n</ul>\n<p><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><br></span><br></p>\n<p><span style=\"color: inherit; font-family: Arial, Helvetica, sans-serif; font-size: 12pt; font-weight: inherit\"><span style=\"color: inherit; font-size: 8pt; font-weight: inherit\"><span style=\"color: rgb(36, 36, 36); font-family: Arial; font-size: 12pt\">-Candidates must be US citizens or Green Card holders. </span><br><span style=\"color: rgb(36, 36, 36); font-family: Arial; font-size: 12pt\">-No sponsorship is permitted as this is a temp-to-hire position. </span><br><span style=\"color: rgb(36, 36, 36); font-family: Arial; font-size: 12pt\">-Hybrid Role - Candidates must currently reside in Arizona and be able to work onsite at one of the Arizona offices at least one day per week.</span><br><span style=\"color: rgb(36, 36, 36); font-family: Arial; font-size: 12pt\">-QNXT experience is strongly preferred and should be clearly reflected on the resume. Please do not submit candidates with assumed or inferred QNXT experience if they have not worked directly within the QNXT platform.</span></span></span></p>",
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