EDI Analyst, Transaction Specialist
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Job Description
Edifecs EDI Analyst managing healthcare transaction workflows, validation, and partner integrations for SAIC’s mission technology services. Troubleshooting HIPAA EDI errors across payer and provider operations.
Responsibilities:
- Own functional EDI workflows, partner requirements, and data validation rules
- Interpret and troubleshoot transaction sets: 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA
- Analyze SNIP compliance, companion guides, and partner-specific validation rules
- Document mapping and logical requirements for new partners and integration changes
- Partner with business stakeholders on issue resolution and operational impact assessments
- Support audit and compliance reviews and maintain data-quality guardrails
- Collaborate with EDI Analysts, DevSecOps Engineers, cloud teams, and business teams
- Identify root causes of transaction errors and resolve mapping mismatches
- Troubleshoot payer or state-system rejections and middleware/API issues
- Query SQL databases and reconcile raw EDI with stored data
Requirements:
- Bachelor’s or master’s degree in computer science, engineering, or a related technical discipline required; equivalent practical experience considered
- Edifecs certification
- Minimum 8 years of Edifecs product experience in EDI, healthcare, or enterprise application operations
- Minimum 8 years EDI/HIPAA experience
- Strong understanding of payer/provider workflows
- Ability to interpret loops/segments/element-level errors
- Familiarity with Edifecs Transaction Management or equivalent tools
- Strong proficiency in X12 / HIPAA EDI transaction structure, rules, and field-level details for 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA
- Understanding of EDI X12 loop/segment/element interpretation, SNIP validations Levels 1–7, companion guide interpretation, and segment- or element-level error analysis
- Experience interpreting Edifecs XEngine validation results, processing rules, and transaction profiles
- Experience with SpecBuilder maps and implementation guides
- Ability to identify issues from Edifecs routes, profiles, or rulesets
- Ability to interpret Edifecs logs and error codes at the functional layer
- Proficiency identifying transaction-error root causes, resolving mapping mismatches, troubleshooting payer or state-system rejections, and reviewing parsed EDI structures in SQL databases
- Ability to understand inbound/outbound workflow architecture
- Experience with AS2, SFTP, and HTTPS flows
- Ability to validate data sent to and received from non-X12 partners
- Ability to identify issues introduced by middleware layers or APIs
- Ability to query SQL for transaction details
- Ability to validate payloads, timestamps, statuses, and error flags
- Ability to reconcile mismatches between raw EDI and stored data
- Ability to communicate technical architecture decisions and trade-offs to non-technical stakeholders
- Experience translating business reporting requirements into technical data models
- Experience with agile methodologies (Scrum, Kanban) and JIRA
- Strong documentation habits, including transaction flow documentation, error trend reports, escalations, SOPs, and partner reference guides
- US Citizenship required with the ability to obtain and maintain a Public Trust clearance
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