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Edi Hipaa Jobs (NOW HIRING)

AleraCare

EDI Claims Specialist

Sandy, UT · On-site

$26 - $32/hr

Ensure compliance with HIPAA EDI standards and internal RCM protocols. * Excellent written and verbal communication, especially when working with payer tech support. Preferred Qualifications:

Kavaliro

EDI Developer

Orlando, FL · On-site

Deep experience with HIPAA X12 transactions: 270/271 (Eligibility), 276/277 (Claim Status), 837P/I ... EDI/X12 processing using EdiFabric or equivalent EDI toolkits * X12 transaction pipelines (837, 835 ...

ShiftCode Analytics

EDI Business Analyst

Boston, MA · On-site

Analyze and validate HIPAA EDI transactions (including 837, 835, 270/271, 275, etc.) to ensure accuracy, compliance, and alignment with business rules. * Work across cross-functional areas-not ...

Apexon

EDI Test Automation Engineer

Nashville, TN · On-site

$44.50 - $58.75/hr

Expertise in ITX , Edifecs , and HIPAA Compliance * Practical experience in Python , C# , and VBScript for automation Key Responsibilities * Develop and execute automated test scripts for various EDI ...

Candid Health

EDI Enrollments Specialist

$22 - $27/hr

You'll maintain HIPAA guidelines Who You Are * You have at least 2 year of experience in revenue ... You may have experience with submitting and troubleshooting EDI enrollments * You have an ...

PDS Health

Specialist, EDI Enrollment

Irving, TX · On-site

$22.60/hr

The Specialist, EDI Enrollment processes the electronic enrollments for dental providers and ... Ensure all documentation is compliant with HIPAA and other relevant regulations to maintain ...

PDS Health

Specialist, EDI Enrollment

Irving, TX · On-site

$22.60 - $29.40/hr

Overview The Specialist, EDI Enrollment processes the electronic enrollments for dental providers ... Ensure all documentation is compliant with HIPAA and other relevant regulations to maintain ...

Integra Partners

Integrations EDI Lead Engineer

Troy, MI · On-site +1

$140K - $140K/yr

HIPAA X12 transactions (837, 835, 270/271, 276/277, 278) * HL7 * FHIR APIs * Define technical architecture and implementation standards for EDI and interoperability solutions. * Lead design reviews ...

Integra Partners

Integrations EDI Lead Engineer

Troy, MI · Remote

$140K - $140K/yr

HIPAA X12 transactions (837, 835, 270/271, 276/277, 278) * HL7 * FHIR APIs * Define technical architecture and implementation standards for EDI and interoperability solutions. * Lead design reviews ...

USM

Urgent Need EDI Claims / .NET Developer

Boise, ID · On-site

HIPAA regulations and healthcare administration functions, including claims processing, eligibility ... EDI) transaction sets Experience with transactional and real-time based systems Knowledge of MQ ...

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How much do edi hipaa jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for edi hipaa 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 are the main challenges faced in an EDI HIPAA position?

One of the primary challenges in an EDI HIPAA role is ensuring that all healthcare data exchanges remain compliant with strict HIPAA regulations while keeping up with evolving technology and payer requirements. EDI HIPAA professionals must frequently troubleshoot complex integration issues, remediate data mapping errors, and resolve transmission failures under tight deadlines. Collaboration with healthcare providers, payers, and IT teams is common, demanding strong communication and project management skills. Successfully navigating these challenges helps protect patient privacy and ensures seamless billing, eligibility, and claims processing across healthcare organizations.

What is an EDI HIPAA job?

An EDI HIPAA job involves managing electronic data interchange (EDI) processes related to healthcare transactions while ensuring compliance with HIPAA regulations. Professionals in this role work with healthcare providers, payers, and clearinghouses to facilitate secure electronic claims processing, eligibility verification, and payment transactions. They also troubleshoot EDI issues, map data, and ensure that all transactions meet HIPAA standards for privacy and security. Strong knowledge of EDI formats (such as X12) and compliance requirements is essential for success in this field.

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

To thrive in an EDI HIPAA role, you need in-depth knowledge of Electronic Data Interchange (EDI) standards, HIPAA compliance regulations, and healthcare data workflows, often supported by a degree in health informatics, IT, or a related field. Familiarity with common EDI software such as Sterling Gentran, EDIFACT, or ASC X12, along with understanding of transaction sets like 837 and 835, is crucial, and certifications in HIPAA or healthcare IT are often preferred. Strong attention to detail, analytical thinking, and effective communication help professionals manage sensitive data and collaborate with technical and non-technical teams. These competencies are critical to ensuring the secure, accurate, and compliant exchange of healthcare information between organizations.

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What cities are hiring for Edi Hipaa jobs? Cities with the most Edi Hipaa job openings:
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Edi Hipaa jobs near you
Infographic showing various Edi Hipaa job openings in the United States as of June 2026, with employment types broken down into 94% Full Time, 1% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $117,659 per year, or $56.6 per hour.
EDI Claims Specialist

EDI Claims Specialist

AleraCare

Sandy, UT • On-site

$26 - $32/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Job description

Position Summary:
The EDI claim specialist is responsible for managing and maintaining all electronic data interchange (EDI) activities between AdvancedMD, Waystar, and associated payers. This role ensures clean, timely, and compliant transmission of claims, remits, and eligibility files. The ideal candidate will serve as a central point of contact for EDI enrollments, troubleshooting, and transmission issues while supporting billing operations across multiple states and payers.
Key Responsibilities:
  • Manage and monitor EDI transmissions via AdvancedMD and Waystar, including 837, 835, 999, 277CA, and eligibility (270/271) files.
  • Oversee and track EDI enrollment setup and status for new and existing payers across all states.
  • Investigate and resolve EDI rejections, failed batches, and clearinghouse errors.
  • Differentiate claim-content rejections - driven by claim/scrubber edits, coding errors, or payer policy and medical-policy changes - from transmission and enrollment failures, and route root cause back to billing, coding, and credentialing for correction.
  • Liaise with payer EDI departments and Waystar support to ensure file compliance and resolution of delays.
  • Work with internal billing, credentialing, and IT teams to ensure accurate mapping and payer ID usage in AMD.
  • Maintain accurate documentation of payer-specific rules, enrollment timelines, and transmission processes.
  • Validate that all ERA (835) files are posting correctly and reconcile any gaps in remittance data.
  • Regularly review and report on EDI performance metrics, rejection rates, and trends.
  • Assist in testing new file formats, NPI/tax ID enrollments, and payer migrations within AMD and Waystar.

Required Qualifications:
  • 2+ years of experience with EDI in a healthcare billing or RCM environment.
  • Strong medical billing background working command of CPT/HCPCS and J-codes, ICD-10, modifiers, units/NDC, and NCCI/MUE edits sufficient to read a 277CA or scrubber edit and identify the underlying coding or payer-policy cause of a rejection.
  • Proven ability to manage payer-specific EDI setup and escalations.
  • Ensure compliance with HIPAA EDI standards and internal RCM protocols.
  • Excellent written and verbal communication, especially when working with payer tech support.

Preferred Qualifications:
  • Experience with multi-state payer setups and crosswalk management inPMS.
  • Hands-on experience with AdvancedMD and Waystar clearinghouse systems.
  • Working knowledge of claims workflows in infusion services or specialty clinics.
  • Familiarity with ERA auto-posting logic and reconciliation.
  • Experience coordinating with offshore teams or large RCM departments.

Work Environment:
  • Remote or hybrid work options available.
  • Occasional scheduled meetings with billing team, payers, and vendors.
  • Cross-functional collaboration with RCM, credentialing, and tech support.

About Pure Infusion
Pure Infusion is a leading healthcare infusion services company providing high-quality, patient-centered infusion therapy across multiple clinic locations. We have been recognized as the fastest-growing company in Utah for two years in a row as of October 2025. Born from the merger of Pure Infusion Suites and Aleracare, we are building a unified organization grounded in a strong culture of excellence, accountability, and genuine care for patients and employees alike. Headquartered in Salt Lake City, Utah, with operations spanning multiple states, we are in a pivotal stage of growth and integration and we're looking for people who want to help shape what comes next.
If you've been looking for a healthcare position that truly allows you to love on, personally care for, and intentionally work with patients without the chaos of traditional healthcare systems, then Pure is likely what you have been waiting for, we hope you'll keep reading.
OUR CORE VALUES
We live by four core values that define our culture and guide our hiring:
• People-obsessed
• Relentlessly Improving
• Innovators
• Grateful
In addition to a competitive rates, we offer the following benefits:
• 401(k) Matching
• Health, Vision, and Dental Insurance
• Over 20 days of paid time off annually
The pay range for this role is:
26 - 32 USD per hour (Sandy HQ)

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