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Edi 837 Jobs in Raleigh, NC (NOW HIRING)

Innosoul inc

EDI Tester

Raleigh, NC · On-site

NC-803026 Hybrid/Local Govt EDI Tester (15+) with X12/837/277CA/834/TA1/999/820/NCPDP, HIPAA, Claims/Provider/Eligibility, Medicaid/MMIS, Agile experience Location: Raleigh, NC (NCDHHS-AM) Duration ...

STI

EDI Specialist

Raleigh, NC · On-site

... for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 • Develop and execute test scripts related to X12 Transmission Conducts QA and Testing on EDI applications Develop and execute Test scripts ...

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EDI Specialist- REMOTE

Raleigh, NC · On-site

EDI (Electronic Data Interchange) Specialist- REMOTE Don't miss this REMOTE opportunity to work as an EDI Specialist for an Industry-Leading Global Company! What You'll Get: As the EDI Specialist ...

All JobsEdi 837 JobsEdi 837 Jobs in Raleigh, NC

Edi 837 information

See Raleigh, NC salary details

$37.4K

$82.7K

$131.2K

How much do edi 837 jobs pay per year?

As of Aug 7, 2026, the average yearly pay for edi 837 in Raleigh, NC is $82,711.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,700.00 and $97,700.00 per year, depending on experience, location, and employer.

What are some common challenges faced by professionals working with EDI 837 transactions, and how can they be addressed?

Professionals working with EDI 837 transactions often encounter challenges such as ensuring data accuracy, managing compliance with HIPAA regulations, and troubleshooting rejected claims due to syntax or mapping errors. Staying updated with payer-specific requirements and understanding the nuances of healthcare claim data are crucial to minimize errors. Collaborating closely with IT, billing, and compliance teams can help resolve issues quickly and maintain smooth claim submissions. Regular training and leveraging robust EDI validation tools are also key strategies for overcoming these challenges.

What is an EDI 837?

An EDI 837 is an electronic data interchange (EDI) transaction set used by healthcare providers to submit healthcare claim information to payers, such as insurance companies. The 837 form replaces traditional paper claim forms and streamlines the process of billing for medical services. It ensures that claims are transmitted securely, accurately, and in a standardized format, which helps reduce errors and speeds up reimbursement. There are different types of 837 transactions, including those for institutional, professional, and dental claims.

What are the key skills and qualifications needed to thrive as an EDI 837 specialist, and why are they important?

To thrive as an EDI 837 Specialist, you need a strong understanding of healthcare claims processing, EDI transaction sets (especially 837), and knowledge of HIPAA regulations, often supported by experience in healthcare IT or revenue cycle management. Familiarity with EDI translation software, clearinghouse platforms, and mapping tools like Sterling B2B Integrator or Edifecs is typically required. Strong analytical skills, attention to detail, and effective communication are essential soft skills for troubleshooting issues and collaborating with providers and payers. These skills ensure accurate and compliant transmission of healthcare claim data, minimizing errors and optimizing reimbursement cycles.

What is the difference between Edi 837 vs Medical Billing Specialist?

AspectEdi 837Medical Billing Specialist
Primary RoleElectronic submission of healthcare claimsProcessing and managing healthcare billing and claims
Required SkillsKnowledge of EDI standards, coding, and claim submissionBilling procedures, coding, insurance verification
Work EnvironmentHealthcare providers, insurance companies, billing servicesMedical offices, billing companies, healthcare facilities
CertificationsOften requires knowledge of EDI standards, coding certificationsMedical billing certifications (e.g., CPC, CBCS)

While Edi 837 focuses on the electronic transmission of healthcare claims using specific standards, the Medical Billing Specialist handles the overall billing process, including claim submission, follow-up, and insurance communication. Both roles are essential in healthcare revenue cycle management but differ in scope and technical focus.

What are popular job titles related to Edi 837 jobs in Raleigh, NC? For Edi 837 jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Edi 837 jobs in Raleigh, NC look for? The top searched job categories for Edi 837 jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Edi 837 jobs? Cities near Raleigh, NC with the most Edi 837 job openings:
Edi 837 jobs near you
Infographic showing various Edi 837 job openings in Raleigh, NC as of August 2026, with employment types broken down into 87% Full Time, 3% Part Time, and 10% Contract. Highlights an 82% Physical, 6% Hybrid, and 12% Remote job distribution, with an average salary of $82,711 per year, or $39.8 per hour.

EDI Tester

Innosoul inc

Raleigh, NC • On-site

Other

Posted 4 days ago

Job description

Job ID: NC-803026

Hybrid/Local Govt EDI Tester (15+) with X12/837/277CA/834/TA1/999/820/NCPDP, HIPAA, Claims/Provider/Eligibility, Medicaid/MMIS, Agile experience

Location: Raleigh, NC (NCDHHS-AM)
Duration: 2 Months

Skills:
Expert in developing and executing test scripts related to X12 EDI Transmission Required 7 Years
Demonstrated proficiency in conducting QA and testing on EDI applications Required 5 Years
Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 Required 5 Years
High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions. Required 5 Years
Strong understanding of healthcare claims processing Claims, Provider, Eligibility Highly desired
Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing Required 2 Years
Experience in creating and managing catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0 Required 3 Years
Working knowledge of Medicaid and/or MMIS Highly desired
Excellent verbal and written communication skills with the ability present to both technical and business audiences. Desired
Proven experience in processing and monitoring all inbound and outbound X12 transactions Required 3 Years
Knowledge of Agile Methodology Required 2 Years
Experience in collaborating with EDI partners to resolve transmission problems. Required 2 Years
LOCAL candidates only Required

Description:
NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist / Tester to perform work related to support the Managed Care Transition Project.

NC Dept of Health and Human Services (DHHS) is seeking a Lead EDI Specialist to perform work related to to support the Medicaid Reform Project.
This position is responsible for the following activities related to a critical system being developed in-house at the State:

High degree of business and technical knowledge with significant practical experience in HIPAA X12 EDI Transactions.
Expert in EDI mapping for 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
Develop and execute test scripts related to X12 Transmission
Conducts QA and Testing on EDI applications
Develop and execute Test scripts related to X12 Transmission
Experience setting up users/new Trading Partner relationship/Standards/Envelope and full cycle testing
Provides technical support during and after implementation for healthcare electronic data interchange applications
Responds to inquiries regarding EDI issues with encounter claims and trading partner activities
Management of catalog of EDI document types such as 837, 277CA, 834, 835, TA1, 999, 820, NCPDP D.0
Communication between Trading Partners and department
Maintain detailed documentation and process flow of all EDI processes
Identify and facilitate issues with partner data mapping from onset through completion
Process and monitor all inbound and outbound X12 transactions
Support Customer Service group with EDI related issues
Identifies, recommends and implements process improvements in support of the EDI system
Troubleshoot EDI document processing errors and work with trading partners directly to resolve in a timely matter
Conducts analysis of EDI transactions and is responsible for documentation and reports
Collaborate with EDI partners to resolve transmission problems.
Track day-to-day EDI & batch processes to identify and address problems as they arise reporting levels of activity using key established metrics for senior management
Effectively communicate issues and needs with internal business partners, external vendors, and healthcare providers
Develops and maintains cross walking and validation rules for file exchanges
Triages incoming EDI issues thru monitoring
Ability to communicate effectively with technical and business staff
Support internal resources to resolve issues, answer questions, and retransmit EDI documents when necessary
Work with end users to ensure user acceptance testing is thorough and complete
Employees should be able to work independently with minimal supervision.
Knowledge of Agile Methodology

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