EDI Specialist

Location: Philadelphia, PA
Salary: $30.00 USD Hourly - $31.00 USD Hourly
Description: Our client is currently seeking a EDI Specialist- Philadelphia, PA

W2 - EDI Specialist-Philadelphia-Hybrid

Philadelphia, PA 19103

Role Summary

This position requires strong expertise in EDI Portal management and inbound EDI enrollment file activity, with responsibility for ensuring successful data transfers, troubleshooting integrity issues, and supporting complex client business processes. The role also involves direct client/team interaction, project participation, and robotic process automation (RPA) oversight.

Key Duties & Requirements

• Manage inbound EDI enrollment file activity and troubleshoot/reconcile data integrity issues.
• Handle EDI file activity for high-profile/complex client business (BPO, Shared Services, non-standard).
• Serve as direct contact between EDI senders, clients, Account Management, Customer Experience, BizTalk/.Net, and project teams.
• Lead/participate in project meetings, sprint work, documentation, system upgrades, and business check-outs.
• Manage robotic process automation (RPA) work for the business area.
• Support Business Systems Analyst with client-specific EDI enrollment testing.

Additional Responsibilities

• Develop user system documentation and desk-level procedures.
• Manage daily team inventory activity; provide support/training/direction to Eligibility Specialists.
• Participate in Enrollment Resolver Group for issue resolution.
• Organize/disperse team project work.
• Assist with manual enrollment processing across all lines of business.
• Support Member Enrollment System platform (development, inquiries, EDI file activity).
• Meet departmental quality and production standards.
• Perform other duties as assigned by leadership.

Qualifications

• Ability to work with multiple business systems; general understanding of system design.
• Proficiency in Microsoft Office and project management tools.
• Strong oral and written communication skills.
• Detail-oriented with understanding of corporate business systems.
• Ability to work independently and investigate/test/present findings.
• Technical writing skills.
• Related enrollment experience in Health Rules system platform; understanding of Front Office System and EDI Portal interaction.

Education & Experience

• Bachelor's degree in Business Administration, MIS, Computer Science, or equivalent healthcare/technology experience.
• Knowledge of XML/ANSI 834 / HIPAA X12 transactions beneficial.
• In lieu of degree: 2-3 years proven EDI/eligibility experience.
• Strong communication and analytical skills required.

Scope

• Working knowledge and experience in discipline.
• Builds knowledge of organization, processes, and customers.
• Performs straightforward assignments using prescribed guidelines/policies.
• Receives moderate guidance/direction from senior roles

By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.

Contact:

This job and many more are available through The Judge Group. Please apply with us today!