Seeking an EDI Analyst/Transaction Specialist for healthcare EDI workflows supporting Veterans. 100% remote; contingent upon contract award.
EDI Analyst/Transaction Specialist
Location: 100% Remote (U.S.)
Employment type: Full-time / Direct Hire
Eligibility: U.S. citizen or permanent resident; ability to obtain and maintain Public Trust required.
This opportunity is contingent upon contract award.
Falcon IT & Staffing Solutions is recruiting an EDI Analyst/Transaction Specialist to support healthcare transaction processing for Veterans. You will own functional EDI workflows, trading-partner requirements, and data-validation rules, working with Edifecs, DevSecOps, cloud, integration, and business teams to improve transaction accuracy and resolve operational issues.
Key Responsibilities
• Interpret and troubleshoot X12/HIPAA transactions, including 270/271, 276/277, 278, 820, 834, 835, 837, and 999/277CA.
• Analyze SNIP compliance, companion guides, and partner-specific validation rules; investigate loop-, segment-, and element-level errors.
• Document mapping and logical requirements for partner onboarding and integration changes.
• Interpret Edifecs XEngine validation results, processing rules, transaction profiles, logs, and error codes at the functional layer.
• Work with SpecBuilder maps and implementation guides; identify issues involving routes, profiles, rulesets, mapping mismatches, and payer or state-system rejections.
• Query SQL databases to validate transaction details, payloads, timestamps, statuses, and error flags; reconcile raw EDI with stored data.
• Collaborate on AS2, SFTP, and HTTPS flows; validate non-X12 partner exchanges and investigate middleware or API issues.
• Partner with business stakeholders on issue resolution and operational impact assessments, audit reviews, compliance, and data quality.
• Maintain transaction-flow documentation, error-trend reports, escalation materials, SOPs, and partner reference guides.
Required Qualifications
• At least eight years of Edifecs product experience in EDI, healthcare, or enterprise application operations.
• At least eight years of EDI/HIPAA experience and strong knowledge of payer/provider workflows.
• Edifecs certification.
• Strong knowledge of X12 transaction structures, SNIP Levels 1–7, companion guides, and field-level validation.
• Familiarity with Edifecs Transaction Management or equivalent tools, XEngine validation, SpecBuilder, and inbound/outbound integration workflows.
• SQL skills for transaction investigation and data reconciliation.
• Ability to translate business reporting requirements into technical data models and explain technical decisions to non-technical stakeholders.
• Experience with Agile methods, Scrum or Kanban, and Jira; ability to resolve ambiguous technical issues with limited direction.
• Strong communication, stakeholder engagement, analytical, and documentation skills.
• Bachelor's or master's degree in Computer Science, Engineering, or a related technical discipline; equivalent practical experience considered.
• U.S. citizenship or permanent residency and ability to obtain and maintain Public Trust.
Preferred Qualifications
• Healthcare payer, PBM, clearinghouse, or pharmacy operations experience.
• Knowledge of HIPAA compliance in cloud data architecture.
• AWS certification.
How to Apply
Apply with your updated resume, or email recruiters@falconitss.com with “EDI Analyst/Transaction Specialist” in the subject line.
Falcon IT & Staffing Solutions is a Service-Disabled Veteran-Owned Small Business (SDVOSB) and an Equal Opportunity Employer.