Claims EDI Operations Specialist

The Claims EDI Operations Specialist is responsible for managing the technical and administrative lifecycle of claims data, with a primary focus on Electronic Data Interchange (EDI) transactions. This role serves as the technical liaison between the Claims team, IT, and external trading partners, ensuring the accuracy of 834, 835, and 837 file transmissions. In partnership with Claims Leadership, this specialist identifies, evaluates, and optimizes claims workflows, data integrity, and system performance. ( Remote) Responsibilities and Duties: Responsibilities include, but are not limited to the following: EDI & Data Management (Core Focus) Manage the end-to-end lifecycle of EDI transactions (834/835/837), including file programming, validation, output, and error resolution. Serve as the primary liaison for trading partners, clearinghouses, payers, and vendors to troubleshoot transmission failures and rejection codes. Manage file generation and uploads and ensure compliance with x12 fo...

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