Electronic Data Interchange Business Analyst

Job Title: Senior EDI Analyst / Business Systems AnalystExperience: 8+ YearsWork Location: Pan IndiaWork Mode: Work from Office (5 days)Project Type: Development / SupportSkill Category: EDI / Business AnalysisJob DescriptionWe are seeking a highly skilled Senior EDI Analyst / Business Systems Analyst with extensive experience in healthcare payer systems, HIPAA X12 transactions, and integration platforms. The ideal candidate will have a strong background in end-to-end EDI workflows, production support, and seamless integration with internal systems and external trading partners.Key Responsibilities- Monitor and support daily EDI transaction flows (837, 835, 278, 834, 270/271) across multiple payer and provider integrations. - Troubleshoot and resolve production issues, including edit errors, rejected files, mapping discrepancies, and reprocessing corrected X12 transactions. - Collaborate with trading partners to validate Authorization (278) and Claims EDI workflows. - Develop functional specifications, source-to-target mappings, data flow diagrams, and traceability documentation. - Create job aids and process documentation for production support and new integrations. - Participate in UAT execution, SQL validation, and post-deployment verification. - Design and support end-to-end trading partner integrations using Cleo Cloud, EDI Fabric, and SQL-based validation. - Lead EDI production support activities including mapping error resolution, reprocessing failed transactions, and partner testing. - Document workflows, ICDs, and interface specifications; collaborate with QA for regression and UAT cycles. - Deliver Medicaid and MMIS solutions through FACETS, covering Claims, Eligibility, NCPDP D.0, and Prior Authorization modules. - Conduct JAD sessions, create BRDs/FRDs, document end-to-end process flows, and perform gap analysis. - Validate backend data using SQL and support UAT and production rollout for claims pricing and member eligibility.Core Competencies- EDI & HIPAA Transactions: 837, 835, 278, 834, 270/271, SNIP validation - Integration Engines: Cleo, Sterling, Mirth, Boomi, BizTalk - Claims & UM Systems: FACETS, MMIS, Utilization Management workflows - EDI Production Support: Mapping resolution, reprocessing, edits, resubmissions - Data Analysis: SQL, relational databases (SQL Server, Oracle, MySQL, DB2) - Documentation: BRD, FRD, ICD, data mapping, Visio workflows, job aids - Agile Delivery: Scrum, SAFe, Kanban, backlog refinement, user story creation - Healthcare Domain: Eligibility, provider data, claims adjudicationTechnical Skills- EDI Standards: ANSI X12 (837, 835, 834, 278, 270/271, 810, 850), HL7, NCPDP D.0 - Integration Platforms: Mirth, Boomi, BizTalk, Cleo, IBM Sterling - Healthcare Platforms: FACETS, Epic, Cerner, Salesforce, Hansen, Edifecs - Databases: SQL Server, Oracle, MySQL, DB2 - Tools: SQL Developer, JIRA, HP ALM, SoapUI, Visio, Lucidchart - Reporting: Power BI, Tableau, Crystal Reports - Methodologies: Agile/Scrum, Kanban, SAFe, Waterfall

Apply Now