EDI Analyst

TEKVANA INC.

Sr. EDI Analyst responsible for leading development and testing of enrollment files.

Posted 7/14/2026full-timeNew York • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in EDI 834 Enrollment transactions and health plan enrollment processes, with a strong ability to translate complex business rules into technical specifications. Proficient in documentation, troubleshooting, and compliance with Marketplace/Open Enrollment requirements.

Highest-signal resume keywords

EDI 834 Enrollment TransactionsHealth Plan Enrollment ProcessesMarketplace/Open Enrollment InitiativesBusiness Requirements DocumentationAnalytical and Troubleshooting Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Technical SpecificationsProcess FlowsWorkflow DiagramsSystem TestingEnrollment Processing Validation

Soft Skills

Excellent Communication SkillsCollaboration Across Teams

Industry Keywords

Enrollment File IssuesBusiness Rules InterpretationRegulatory ComplianceNew York State Marketplace RequirementsEligibility Changes Assessment

About the role

Key responsibilities & impact

Lead the development, validation, and testing of EDI 834 enrollment files.
Troubleshoot enrollment file issues and identify root causes.
Interpret enrollment business rules and translate them into technical specifications.
Provide guidance on state-specific and Marketplace/Open Enrollment requirements.
Create detailed technical enrollment scenarios to support system testing and implementation.
Convert business needs into clear technical requirements and functional documentation.
Define expected system behavior and validate enrollment processing.
Support enrollment operations teams by resolving complex enrollment and eligibility issues.
Document business and technical requirements, workflows, and process documentation.
Develop process flows and workflow diagrams.
Act as a liaison between business stakeholders and IT teams to ensure successful implementation of enrollment initiatives.
Monitor regulatory and Marketplace rule changes, particularly those impacting Open Enrollment.
Interpret New York State Marketplace enrollment requirements and ensure compliance.
Assess downstream impacts of enrollment and eligibility changes across integrated systems.
Support planning, testing, and readiness activities for Open Enrollment.

Requirements

What you’ll need

Extensive experience working with EDI 834 Enrollment transactions within a health plan environment
Strong knowledge of health plan enrollment and eligibility processes
Experience supporting Marketplace/Open Enrollment initiatives
Ability to interpret complex business rules and convert them into technical requirements
Experience documenting business requirements, technical specifications, and process flows
Strong analytical and troubleshooting skills
Excellent communication skills with the ability to work effectively across business and technical teams.

Benefits

Comp & perks

Flexible work from home options