EDI Specialist jobs in United States
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IntePros · 6 hours ago

EDI Specialist

IntePros is a company focused on managing and supporting EDI enrollment activities. The EDI Specialist will ensure the accurate transfer of enrollment data, serve as a liaison between teams, and support both operations and project initiatives in a healthcare environment.

ConsultingInformation TechnologyStaffing Agency
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Senior Management
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H1B Sponsor Likelynote

Responsibilities

Manage inbound EDI enrollment file activity through the EDI Portal, ensuring successful data transfer and validation
Monitor, troubleshoot, and reconcile data integrity issues related to inbound EDI enrollment files
Support complex and high-profile EDI client implementations, including BPO, Shared Services, and non-standard business models
Perform and support client-specific EDI enrollment testing in coordination with Business Systems Analysts
Assist with manual enrollment processing across all lines of business as needed
Support enrollment-related issue resolution as part of the Enrollment Resolver Group
Serve as a primary point of contact between EDI senders, clients, Account Management, Customer Experience, BizTalk/.NET teams, and project teams
Communicate clearly and effectively with technical and non-technical stakeholders to resolve issues and drive outcomes
Lead and/or participate in project meetings, sprint work, system upgrades, and business check-outs
Contribute to business requirements documentation and system enhancement initiatives
Support the Member Enrollment System platform, including development work, inquiries, and EDI file activity
Manage all Robotic Process Automation (RPA) work for the assigned business area
Assist in the development and maintenance of user system documentation and desk-level procedures
Manage daily team inventory and workflow activities
Provide guidance, training, and support to Eligibility Specialist team members
Organize and distribute project work across team members to ensure timely completion
Meet or exceed departmental quality and production standards

Qualification

EDI enrollment expertiseHealth Rules systemsSystem designIntegrationAnalytical problem-solvingMicrosoft Office proficiencyXML understandingANSI 834 knowledgeHIPAA X12 transactionsTeam supportCommunication skillsDetail-oriented

Required

Strong working knowledge of EDI enrollment processes and EDI Portal functionality
Experience supporting eligibility and enrollment systems, including Health Rules and Front Office systems
Ability to work across multiple business systems with a general understanding of system design and integration
Strong analytical, investigative, and problem-solving skills, with the ability to perform testing and present findings
Excellent written and verbal communication skills, including technical documentation
Proficiency with Microsoft Office products and project management tools
Ability to work independently while managing multiple priorities in a fast-paced environment
Detail-oriented with a solid understanding of corporate business systems and workflows
Bachelor's degree in Business Administration, Management Information Systems, Computer Science, or a related field
OR equivalent work experience in the healthcare or technology space
Minimum of 2–3 years of proven EDI and/or eligibility experience in lieu of a degree

Preferred

Understanding of XML, ANSI 834, and HIPAA X12 transactions strongly preferred

Company

IntePros

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IntePros is an established, woman-owned, privately-held technology and business services consulting agency committed to building long-term relationships and helping more companies leverage the power of a more diverse workforce.

H1B Sponsorship

IntePros has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (3)
2023 (6)
2022 (7)
2021 (6)
2020 (13)

Funding

Current Stage
Growth Stage

Leadership Team

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Loren Kovalcik
CEO
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Company data provided by crunchbase