Healthcare EDI Analyst – Payer Connectivity

Experian

EDI Analyst optimizing payer and trading partner connections for reliable healthcare transactions. Supporting setup, troubleshooting, and operational efficiency in electronic healthcare processes.

Posted 7/1/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $89,865 - $155,767 per yearWebsite

About the role

Key responsibilities & impact

Establish, maintain, and optimize payer and trading partner connections that support reliable electronic healthcare transactions
Research payer requirements, implement and validate connectivity solutions, maintain accurate payer data, and resolve transaction issues across supported workflows
Be the subject matter expert and escalation point for payer connectivity, EDI, API, and web/screen capture issues
Partner with Product, Clearinghouse, Implementation, Engineering, Support, vendors, and trading partners to support setup, troubleshooting, and optimization
Document payer lists, workflows, requirements, research findings, issue resolutions, and reference materials in established systems
Validate and monitor new payer connections to ensure successful transaction exchange
Analyze reporting, dashboards, Salesforce cases, and Jira tickets to identify trends, risks, and improvement opportunities
Support process improvement, automation, and AI-driven projects that improve monitoring, data accuracy, and workflow efficiency
Provide guidance and training on payer connectivity processes and best practices.

Requirements

What you’ll need

5+ years of business analyst, implementation, client/payer-side, or healthcare RCM software/technology experience
3+ years of healthcare eligibility and benefits experience across hospital and/or physician workflows
Strong knowledge of healthcare EDI transactions and workflows, including 270/271, 276/277, 278, 837, and 835
Understanding of payer connectivity models, including direct connections, clearinghouses, trading partners, AS2, SFTP, APIs, and FHIR-based integrations
Research payer requirements, interpret companion guides, and translate requirements into connectivity solutions
Experience analyzing healthcare transaction data, diagnosing connectivity issues, validating outcomes, and managing payer lists or transaction availability data
Experienced with Microsoft 365, Salesforce, Atlassian Jira, reporting tools, and dashboards
Experience with Experian Health platforms, similar healthcare technology solutions, Epic/Cerner, data analysis, automation, or AI-driven solutions.

Benefits

Comp & perks

Great compensation package and bonus plan
Core benefits including medical, dental, vision, and matching 401K
Flexible work environment, ability to work remote, hybrid or in-office
Flexible time off including volunteer time off, vacation, sick and 12-paid holidays

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

Healthcare RCM SoftwareEDI Workflows270/271 Transactions276/277 Transactions278 Transactions837 Transactions835 TransactionsAPI IntegrationsFHIR-based IntegrationsConnectivity Solutions

Soft Skills

Problem SolvingCollaborationTraining