EDI Business Analyst Job at ShiftCode Analytics, Boston, MA

L2pjWGp5ZE9UYW1Ib21QYzhQdVpDVjdPR2c9PQ==
  • ShiftCode Analytics
  • Boston, MA

Job Description

Interview : Video Visa : USC, GC, GC EAD, H4 This is hybrid from day-1 ( Local candidates highly preferred ) Description: Job Summary We are seeking a business-focused EDI Business Analyst to serve as a critical link between the business and IT teams. In this role, you'll work directly with operational stakeholders to gather and translate requirements into clear, actionable deliverables. You will support EDI initiatives across multiple functional areas-including claims, provider portals, and customer service portals-to ensure that technical solutions align with real-world business needs. Primary Responsibilities

  • Partner with business stakeholders to define, document, and refine requirements for EDI-related projects and enhancements.
  • Serve as the liaison between business users and technical teams, translating business needs into functional specifications and user stories.
  • Analyze and validate HIPAA EDI transactions (including 837, 835,, 275, etc.) to ensure accuracy, compliance, and alignment with business rules.
  • Work across cross-functional areas-not limited to claims, but also provider portal and customer service portal initiatives.
  • Participate in testing efforts: create test scenarios, validate EDI data and outputs, and support user acceptance testing (UAT).
  • Troubleshoot issues, identify root causes, and recommend corrective actions.
  • Ensure deliverables meet project timelines, scope, and quality standards.
Education and Experience
  • 5+ years of Business Analyst experience within the healthcare payer / health insurance industry.
  • Strong understanding of EDI standards, including HIPAAX12 transactions.
  • Hands-on experience reviewing and interpreting EDI transaction sets (837, 835,, 275, etc.).
  • Working knowledge of FACETS (Facets Claims Processing system).
  • Excellent communication, facilitation, and documentation skills with a business-first mindset.
  • Experience collaborating across multiple operational domains beyond claims (e.g., provider management, member services, customer service portals).
  • Experience working in Agile/Scrum environments is a plus.
  • Edifecs experience is a plus.

Job Tags

Local area,

Similar Jobs

Wild Dunes Resort

Spa Massage Therapist (Part Time/On Call) Job at Wild Dunes Resort

 ...Grow your career at the Spa at Sweetgrass, ranked number 30 by Spas of America in 2022. Here at the Sweetgrass Spa , our goal is to create memorable experiences for each and every one of our guests and, along the way, each other. We are a team that respects each other;... 

Advanced Search Group

Salon/Spa & Wellness Professionals Job at Advanced Search Group

 ...Job Description Salon/Spa & Wellness Professionals Wanted Booth/Room Rentals Available Location: Carmel, Indiana We are a growing beauty and wellness space in Carmel, Indiana, seeking motivated, licensed professionals to join our salon community. This is a... 

Oracle

Principal Software Engineer Job at Oracle

 ...Job Description As a Principal team member of the software engineering division, you will define and develop software for tasks associated with the developing, debugging or designing of software applications or operating systems. Provide technical leadership to other... 

Greenway Automotive Group

Team One Nissan of Albertville - Automotive Lot Porter Job at Greenway Automotive Group

Keep vehicle lots neat and orderly, moving cars as directed and in accordance with dealership display standards Moves vehicles to maintain flow of traffic Makes key tags for vehicles Retrieves vehicles for customers when picking up, waiting at the ve Automotive, Porter...

Duval Charter School at Baymeadows K-12

3rd Grade Teacher - DCSB K-12 Job at Duval Charter School at Baymeadows K-12

 ...purposeful and appropriate lesson plans which provide for effective teaching strategies and maximizes time on task. Presents subject...  ...to establish and maintain effective working relationships with teachers, students, parents, the community, and administrative staff. Is...