Operations Specialist for EDI Support

Job Summary

To support EDI implementations and post-implementation production, the full-time Operations Specialist for EDI Support will manage onboarding, testing, and operational stability of EDI integrations remotely, acting as the main point of contact for third-party administrators.

Key responsibilities:

• Participate in technical calls and assist in testing 837 outbound files with TPAs to ensure compliance
• Serve as the primary operational contact for TPAs post-implementation, monitoring and resolving production issues
• Develop and maintain detailed SOPs for EDI implementations and ongoing operational tasks, identifying process improvement opportunities

Required qualifications:

• Bachelor's Degree or 1+ years of experience in EDI operations or healthcare data exchange, with hands-on exposure to 834/837 HIPAA transaction sets
• Strong understanding of healthcare claims processing and TPA coordination
• Experience with clearinghouses or healthcare integration platforms preferred
• Background in writing SOPs or internal process documentation
• Previous analytics and reporting skills a plus