Remote Edi Jobs in Philadelphia, PA (NOW HIRING)

Our client is a leading healthcare benefits technology organization specializing in self-funded health plan solutions, healthcare data integration, claims processing, and benefits administration. The company works with employers, healthcare partners, and third-party administrators to improve the way eligibility, claims, and other critical healthcare data move between systems.

They are looking for an experienced EDI Specialist - 834 who can take ownership of healthcare eligibility integrations from requirements and trading partner setup through testing, implementation, production support, and ongoing troubleshooting. This is a hands-on technical role for someone who combines deep X12 834 knowledge with strong implementation, data analysis, SQL, and trading partner experience.

This is a fully remote, long-term contract opportunity supporting a distributed team and external healthcare trading partners. The team primarily operates on Central Time, so candidates should be comfortable aligning their working hours accordingly.

The Role You'll Play

As the EDI Specialist - 834, you will serve as a key technical resource for 834 eligibility integrations and day-to-day EDI processing. You will work directly with business teams, technical resources, clients, and external trading partners to ensure eligibility feeds are properly defined, mapped, tested, implemented, and supported in production.

This role requires someone who understands both the technical and implementation sides of EDI. You need enough technical depth to troubleshoot data and transformation issues, but also the implementation experience to gather requirements, coordinate testing, work directly with trading partners, and drive an 834 implementation through go-live.

• Own and support implementations of X12 834 eligibility feeds, from requirements gathering and trading partner setup through testing, production migration, and post-implementation support.

• Build, modify, and support 834 import and transformation processes based on business, client, and trading partner requirements.

• Monitor inbound 834 transactions and troubleshoot file processing, mapping, data quality, and downstream integration issues.

• Use SQL to analyze enrollment and eligibility data, reconcile transactions, validate results, identify discrepancies, and troubleshoot issues across source and downstream systems.

• Work directly with external trading partners and internal stakeholders to define EDI requirements, companion document specifications, mappings, standards, and processing rules.

• Coordinate full-cycle EDI testing, including QA, regression, integration, and user acceptance testing, while ensuring data and process accuracy prior to production implementation.

• Analyze recurring errors, risk areas, and failure points and identify opportunities to improve, automate, and standardize EDI processes.

• Maintain clear technical documentation, implementation requirements, processing procedures, and EDI data flows.

Background Profile:

The ideal candidate has deep hands-on experience working with X12 834 eligibility transactions in a healthcare environment and has personally participated in, or led, full-cycle EDI implementations. You should be comfortable going beyond simply monitoring files and resolving tickets. This role needs someone who understands how 834 feeds are structured, transformed, validated, implemented, and supported across multiple systems and trading partners.

Strong candidates will also be able to bridge technical and business conversations, work independently in a remote environment, and communicate effectively with external partners when implementation or production issues need to be resolved.

• Strong hands-on experience with X12 834 eligibility transactions, including segments, data elements, envelopes, coding conventions, implementation guides, and trading partner requirements.

• Demonstrated experience leading or owning EDI implementations, including requirements gathering, trading partner setup, mapping, testing, go-live, and production support.

• Experience with EDI translation/transformation software and building, modifying, or supporting healthcare data import and transformation processes.

• Strong SQL skills with experience analyzing enrollment or eligibility data, validating EDI transactions, performing reconciliation, identifying discrepancies, and troubleshooting data issues.

• Experience working directly with external trading partners, clients, business teams, and technical resources to resolve EDI processing and implementation issues.

• Knowledge of healthcare data exchange, HIPAA requirements, and secure file transfer protocols such as SFTP.

• Strong analytical, problem-solving, documentation, and communication skills with the ability to independently manage multiple implementation and production priorities.

• Associate's degree in Business Administration, Computer Science, a related discipline, or equivalent professional experience.