Note: The job is a remote job and is open to candidates in USA. Johnson Service Group (JSG) is seeking an EDI Analyst- Eligibility & Enrollment. The role involves managing daily EDI operations and improving data accuracy while providing customer support for portal management.
Responsibilities
- Manage daily EDI operations, ensuring the proper handling and processing of eligibility and benefit transactions
- Monitor, reconcile, and troubleshoot inbound and outbound EDI files, including 834 benefit enrollment files
- Coordinate system upgrades, file transfers, and resolve EDI transaction issues efficiently
- Collaborate with carriers, vendors, and internal teams to implement fixes and enhancements
- Continuously identify opportunities to improve data accuracy, system efficiency, and operational workflows
- Develop and document Standard Operating Procedures (SOPs) to streamline EDI processes
- Lead initiatives to implement process improvements, reducing risks and increasing productivity
- Communicate key changes and updates effectively to all stakeholders
- Oversee functionalities of customer-facing portals (WERC, PERC, OPIS, Health View) ensuring their reliable performance
- Act as a point of contact for vendors and clients regarding portal and enrollment system issues
- Assist with technical support requests, including account management, security settings, and testing activities
- Collaborate across departments to facilitate new client integrations and enrollment testing
- Promote a culture of curiosity, accountability, and collaboration to help meet organizational goals
- Maintain a HIPAA-compliant workstation, ensuring the security and confidentiality of protected health information
- Perform additional duties as assigned to support organizational success
Skills
- Bachelor's degree in Management Information Systems (MIS), Computer Science, Healthcare Administration, or related field; or three (3) years of relevant experience
- Solid experience working with healthcare EDI transactions, particularly within health benefits administration
- Proficiency in EDI software, tools, and platforms, with strong understanding of data flow, mapping, and troubleshooting
- Knowledge of HIPAA regulations, healthcare eligibility, and enrollment processes
- Strong communication skills, capable of collaborating across technical and non-technical teams
- Demonstrated project management skills, from planning to execution, with attention to detail
- Ability to analyze and resolve complex technical issues efficiently
Benefits
- Medical
- Dental
- Vision
- Life insurance options
- Short-term disability
- 401(k)
- Weekly pay
Company Overview