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Edi Healthcare Jobs (NOW HIRING)

Allcare Health

EDI Developer

Grants Pass, OR · Remote

$75K - $100K/yr

It also moves the national health care model forward for the country, as we're continually on the ... Experience with EDI mapping tools These would be considered assets: * Healthcare EDI or HL7 ...

Infojini Inc

Sr. EDI Analyst

Linthicum Heights, MD

A minimum of four (4) years of experience in analyzing/testing Healthcare/Marketplace EDI Applications. A minimum of two (2) years of experience working with SQL databases/queries. Strong analytical ...

Infojini Inc

Sr. EDI Analyst

Linthicum Heights, MD

A minimum of four (4) years of experience in analyzing/testing Healthcare/Marketplace EDI Applications. A minimum of two (2) years of experience working with SQL databases/queries. Strong analytical ...

Precision Resources

EDI Developer

Dothan, AL · On-site

$90K - $120K/yr

Salary ranges from $90K to $120K and will also include Healthcare, PTO and Vacation Time. We are ... Monitor daily EDI transaction processing. Troubleshoot and resolve EDI processing issues.

Apex Informatics

Facets EDI Consultant

San Jose, CA · On-site

Facets EDI Consultant Location: 100% Remote Duration: 12+ Months Contract We are seeking an ... Technical training or knowledge transfer experience. Healthcare payer domain experience.

New

Cook Systems

EDI Specialist

Tallahassee, FL · On-site

Test, implement, and maintain EDI transactions and trading partner definitions using EDI ... healthcare and dependent-care expenses your way. * Extra Protection When You Need It: Our Health ...

New

MetroPlusHealth

EDI Database Programmer

Manhattan, NY · On-site

$120K - $130K/yr

The successful candidate will possess strong SQL programming and EDI analytical skills, excellent communication abilities, and healthcare experience, including knowledge of membership, provider, and ...

KeySource

EDI Manager

Cincinnati, OH · On-site

Medical, Vision, & Dental Insurance * 401(k) + Company Match * Healthcare Flexible Spending Account ... Experience with EDI 1-2 years * Pharmaceutical distribution industry experience * Demonstrated ...

Keysource Acquisition

EDI Manager

Cincinnati, OH · On-site

Medical, Vision, & Dental Insurance * 401(k) + Company Match * Healthcare Flexible Spending Account ... Experience with EDI 1-2 years * Pharmaceutical distribution industry experience * Demonstrated ...

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How much do edi healthcare jobs pay per hour?

As of Jul 13, 2026, the average hourly pay for edi healthcare in the United States is $56.57, according to ZipRecruiter salary data. Most workers in this role earn between $48.08 and $65.38 per hour, depending on experience, location, and employer.

What does an EDI specialist do?

An EDI specialist manages electronic data interchange systems in healthcare, ensuring the secure and accurate exchange of medical and billing information between providers, payers, and vendors. They configure, test, and troubleshoot EDI transactions using industry standards like HIPAA, often working with EDI software and maintaining compliance with healthcare regulations.

What is an EDI in healthcare?

In healthcare, EDI (Electronic Data Interchange) refers to the electronic exchange of healthcare-related information such as claims, eligibility, and payment data between providers, payers, and other entities. Healthcare EDI specialists manage and implement these data exchanges using standardized formats like ANSI X12 and often require knowledge of healthcare regulations and EDI software tools.

What is the highest paying job in healthcare administration?

The highest paying roles in healthcare administration are often executive positions such as Chief Executive Officer (CEO), Chief Operating Officer (COO), or Chief Financial Officer (CFO), which can earn six-figure salaries. These roles typically require extensive experience, advanced degrees, and strong leadership skills within healthcare organizations or hospital systems.

What is EDI healthcare eligibility?

In healthcare EDI (Electronic Data Interchange), eligibility refers to verifying a patient's insurance coverage and benefits electronically before providing services. EDI systems enable healthcare providers to quickly confirm patient eligibility, streamline billing, and reduce claim denials using standardized transaction formats like 270/271 transactions. Accurate eligibility verification is essential for efficient claims processing and reimbursement.

What is an EDI Healthcare job?

An EDI Healthcare job involves managing electronic data interchange (EDI) systems to securely exchange healthcare information between providers, insurers, and other stakeholders. Professionals in this role ensure compliance with HIPAA regulations, troubleshoot EDI transactions, and optimize data workflows for billing, claims processing, and patient records. Strong knowledge of healthcare EDI standards, such as X12 and HIPAA-compliant transactions, is essential.

What are the typical daily responsibilities for someone working in an EDI Healthcare role?

On a daily basis, EDI Healthcare professionals are responsible for managing and troubleshooting electronic data interchange transactions between healthcare providers, payers, and clearinghouses. They monitor data file transmissions, resolve errors or rejections, and ensure compliance with regulatory standards like HIPAA. Additionally, they often collaborate with IT teams, business analysts, and healthcare staff to implement EDI solutions or updates. This role requires a proactive approach to identifying process improvements and maintaining the integrity and security of sensitive healthcare data.

What are the key skills and qualifications needed to thrive in the Edi Healthcare position, and why are they important?

To excel in an EDI Healthcare role, you need a solid understanding of healthcare data exchange, HIPAA regulations, and experience with EDI transaction sets such as 837, 835, and 270/271, often supported by a degree in healthcare administration, information technology, or a related field. Familiarity with EDI translation software, clearinghouse platforms, and relevant certifications like Certified Electronic Health Records Specialist (CEHRS) are highly valued. Strong analytical thinking, attention to detail, and effective communication skills help EDI professionals collaborate with both technical teams and healthcare providers. These competencies are crucial for ensuring seamless, secure, and compliant data exchange in the healthcare ecosystem.

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Edi Healthcare jobs near you
Encounter Data Engineer (EDI, Managed Care)

Encounter Data Engineer (EDI, Managed Care)

MetroPlusHealth

Manhattan, NY • On-site

$125K - $130K/yr

Full-time

Re-posted yesterday

MetroPlusHealth rating

7.8

Company rating: 7.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

169th of 281 rated insurance

Job description

The position of Encounter Data Engineer in the Analytics and Reporting Department is responsible in managing encounter data submission to NYSDOH, CMS and other regulatory entities as required. The responsibility includes troubleshooting EDI mapping issues, Encounter data reporting errors, monitoring Encounter Data Quality reports, ensuring adherence to EDI standards, writing complex SQL Queries and stored procedures, SSIS jobs for EDI file submission, and troubleshooting EDI error records. Additionally, this role is responsible for developing and maintaining EDI documentation including process flow and cross-functional team collaboration regarding identification of EDI problem areas. Lastly, the Encounter Data Engineer is responsible for preparing test data, conditions and expected results to verify new EDI updates and logic.
The successful candidate must have strong SQL programming skills, EDI Analytical skills, communication skills, and healthcare experience with knowledge in membership, provider, and claims data.
Scope of Role & Responsibilities
  • Monitor and submit Encounter Data files to NYSDOH OSDS and CMS.
  • Collaborate with vendors/end users on correcting EDI error transactions and resubmissions to NYSDOH and CMS.
  • Automate manual processes for Encounter Data submissions.
  • Support the Compliance and Regulatory department for any inquiry on Encounter Data processes.
  • Support MMCOR reporting
  • Create KPI reports on Encounter Data reporting.
  • Create SQL stored procedures and flow diagrams and document the process for Encounter Data Reporting.
  • Troubleshoot EDI Errors and keep track of all the resubmissions.

Required Education, Training & Professional Experience
  • Bachelor's degree in Information Systems, Computer Science, Database Management, or related field.
  • Minimum 5 years of programming experience in SQL Server database object development including but not limited to stored procedures, functions, views, SSIS and SSRS, X12 EDI mapping and development, and troubleshooting EDI errors.
  • Minimum 3 years' experience in complex healthcare data like Claims and Enrollment.
  • Working knowledge of EDI X12 Standards
  • Previous experience in BI reporting tools, such as BusinessObjects, Tableau, or Power BI
  • Knowledge of Visual Studio, .Net Development, XML, BizTalk.

Professional Competencies
  • Integrity and Trust
  • Collaboration and Time management skills
  • Functional/Technical skills
  • Written/Oral Communication
  • Ability to work effectively in a team environment and adapt to different projects and assignments quickly.
  • Excellent analytical and problem-solving skills

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