Enrollment Data Analyst

Job Summary

To ensure the accuracy and integrity of member enrollment data, the full-time remote Enrollment Data Analyst will manage the end-to-end lifecycle of enrollment data, including processing HIPAA 834 files, conducting data validation, and collaborating with cross-functional teams.

Key Responsibilities

• Configure and troubleshoot inbound and outbound HIPAA 834 transaction files, ensuring compliance and resolving discrepancies
• Perform systematic validation of enrollment records and execute data quality audits to identify anomalies and ensure data accuracy
• Accurately enter and maintain member demographic and eligibility data while leading data cleanup projects to address discrepancies

Required Qualifications

• 2+ years of experience in health plan enrollment operations, managed care, or EDI data processing
• Hands-on experience with HIPAA 834 transaction processing and X12 EDI standards
• Proficiency in SQL for querying and validating enrollment data against relational databases
• Experience with claims administration systems such as Plexis QC, QNXT, or similar
• Familiarity with ACA eligibility and enrollment rules, CMS guidelines, and HIPAA data privacy