Healthcare EDI 834 Functional Analyst - ONLY W2

-----------ONLY W2-------------------ONLY W2------------------ONLY W2-----------

*******Candidate MUST reside in any of these states DC, MD, VA, WV, PA, DE***********

Title: Healthcare EDI 834 Functional Analyst

Location: Baltimore, MD 21224 (Remote)

Duration: 6 Months Contract to hire

Job Description:

Terms of Employment:

• W2 Contract-to-Hire; 6-Months
• 100% Remote (Must reside in the DMV / local surrounding region for mandatory quarterly in-office meetings);
• Schedule: 8:30 AM 5:00 PM EST

Overview:

• Work with a leading regional healthcare payer organization assisting in the onboarding and implementation of new commercial accounts. This Functional Analyst will play a key role in managing EDI 834 eligibility file feeds, validating file specifications, conducting rigorous data testing and auditing, and serving as a technical liaison to third-party administrators and vendors to ensure seamless account go-lives ahead of peak renewal seasons.

Key Responsibilities:

• Lead the end-to-end onboarding and implementation of new commercial account EDI file feeds (ranging from 50 to 1,000+ member groups).
• Analyze, validate, and audit EDI 834 eligibility files to ensure file layouts match specific vendor requirements and match active members in the claims system.
• Perform thorough data analysis and end-to-end testing of file feeds prior to promoting data into the production claims environment.
• Interface directly with external vendors, third-party administrators (TPAs), and client teams to resolve data discrepancies, clarify specifications, and answer technical questions.
• Collaborate with cross-functional teams to ensure smooth account setup during high-volume renewal periods.

Required Qualifications:

• Minimum of 4 years of progressive functional/business analysis experience and a Bachelor s degree.
• In lieu of a bachelor s degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
• Mandatory hands-on expertise with EDI 834 eligibility file layouts and feed processes.
• Direct experience working with the Facets claims platform (Facets G6 or Facets Legacy).
• Proven experience in data analysis, data auditing, and testing within a healthcare claims environment.
• Strong verbal and written communication skills with experience in vendor-facing or third-party client interaction.
• Must reside within the DMV or local commuting region (Southern PA, DE, local WV) and be open to attending quarterly in-office meetings.
• Ability to adhere to fixed core working hours of 8:30 AM to 5:00 PM EST.

Preferred Qualifications:

• Prior experience utilizing Edifex software for EDI mapping/processing.
• Background in Healthcare Business Analysis, Data Analysis, Claims Analysis, or Quality Assurance (QA).
• Experience handling commercial book of business implementations.

Sincerely,

Preetam Raj

Lead Technical Recruiter

nTech Workforce Inc.

D: EXT: 726

E: