Healthcare EDI Analyst - Payer Connectivity (Remote)

Job Description

The EDI Analyst – Payer Connectivity establishes, maintains, and optimizes payer and trading partner connections that support reliable electronic healthcare transactions. You will research payer requirements, implements and validates connectivity solutions, maintains accurate payer data, and resolves transaction issues across supported workflows. You will be a subject matter expert and escalation point, partnering with our teams and external partners to improve connectivity reliability, scalability, and operational efficiency.

You'll have opportunity to:

• Research payer requirements and establish new direct or trading partner connectivity solutions.·
• Maintain payer connectivity data, including payer IDs, transaction availability, connection type, and status.
• Be the subject matter expert and escalation point for payer connectivity, EDI, API, and web/screen capture issues.
• Partner with Product, Clearinghouse, Implementation, Engineering, Support, vendors, and trading partners to support setup, troubleshooting, and optimization.
• Document payer lists, workflows, requirements, research findings, issue resolutions, and reference materials in established systems.
• Validate and monitor new payer connections to ensure successful transaction exchange.
• Analyze reporting, dashboards, Salesforce cases, and Jira tickets to identify trends, risks, and improvement opportunities.
• Support process improvement, automation, and AI-driven projects that improve monitoring, data accuracy, and workflow efficiency.
• Provide guidance and training on payer connectivity processes and best practices.

Qualifications

• 5+ years of business analyst, implementation, client/payer-side, or healthcare RCM software/technology experience.
• 3+ years of healthcare eligibility and benefits experience across hospital and/or physician workflows.
• Strong knowledge of healthcare EDI transactions and workflows, including 270/271, 276/277, 278, 837, and 835.
• Understanding of payer connectivity models, including direct connections, clearinghouses, trading partners, AS2, SFTP, APIs, and FHIR-based integrations.
• Research payer requirements, interpret companion guides, and translate requirements into connectivity solutions.
• Experience analyzing healthcare transaction data, diagnosing connectivity issues, validating outcomes, and managing payer lists or transaction availability data.
• Experienced with Microsoft 365, Salesforce, Atlassian Jira, reporting tools, and dashboards.
• Experience with Experian Health platforms, similar healthcare technology solutions, Epic/Cerner, data analysis, automation, or AI-driven solutions.

Additional Information

Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
• Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html

At Experian, our people and culture set us apart. We're deeply committed to creating an environment where everyone feels they belong and can excel. From inclusion and authenticity to work/life balance, development, wellness, collaboration, and recognition, we focus on what truly matters. Our people-first approach has earned us global recognition: World's Best Workplaces™ 2024 (Fortune Top 25), Great Place To Work™ 2025 in 26 countries, and Glassdoor Best Places to Work 2024, among others.

Want to see what life at Experian is really like? Explore Experian Life on social or visit our careers site.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.