See all roles

EDI Healthcare Analyst-NO C2C /MUST Live in PST

Work from home Full-time role Hiring

Johnson Service Group (JSG) is seeking an EDI Analyst- Eligibility & Enrollment.

Remote. Must live in Pacific, Mountain or Central time zones.

Work Schedule: Monday-Friday 8:00am- 5:00pm

Key Responsibilities

Electronic Data Exchange

  • 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.

Business Process Improvement

  • 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.

Customer Support & Portal Management

  • 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.

Other Duties

  • 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.

Qualifications

  • 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.

Additional Benefits

JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more. Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

apply to this job

You might like

Principal Business Intelligence Analyst - Rev C...

Work from home Full-time role

Atomic Monster + Blumhouse Casting for 'Foliage...

Work from home Full-time role

Specialist, Broadband - Pontiac, MI

Work from home Full-time role

Specialist, Broadband

Work from home Full-time role

Freight Conductor

Work from home Full-time role

Membership Marketing Assistant (Remote | PT | M...

Work from home Full-time role

Intermodal Service Employee

Work from home Full-time role

Intermodal Service Employee

Work from home Full-time role

Intermodal Service Employee

Work from home Full-time role

Game Tester – Entry Level (Work From Home, No E...

Work from home Full-time role

Experienced Customer Service Professional - Chat Support Representative for Dynamic Financial Services Company - arenaflex - Remote Work Opportunity

Work from home Full-time role

Legal Counsel- Senior Counsel job at Tris Pharma in Monmouth Junction, NJ

Work from home Full-time role

Senior Regulatory Reporting Accountant

Work from home Full-time role

VP, Product Manager, Marketplace API and Digital Tools

Work from home Full-time role

Immediately Require English Tutor – Work from Home in Huntington, WV

Work from home Full-time role

Health Care Analyst I

Work from home Full-time role

Director of Fleet Business Development

Work from home Full-time role

Key Account Director (Exelon)

Work from home Full-time role

Experienced Customer Success Advocate II – Driving Business Growth and Customer Satisfaction at arenaflex

Work from home Full-time role

B2B Email Marketing Specialist (Clinical Research, 3+ years experience)

Work from home Full-time role