EDI Analyst

At Zelis we Get Stuff Done. So lets get to it!

A Little About Us

Zelis is modernizing the healthcare financial experience across payers providers and healthcare consumers. We serve more than 750 payers including the top five national health plans regional health plans TPAs and millions of healthcare providers and consumers across our platform of solutions. Zelis sees across the system to identify optimize and solve problems holistically with technology built by healthcare experts driving real measurable results for clients.

At Zelis AI is woven into the fabric of how we work. Every associate is expected - and empowered - to partner with AI to challenge the status quo accelerate innovation and amplify their impact. This is a place for builders with a growth mindset who act with agility embrace change and use modern technology to shape smarter solutions exceptional experiences and the future of our industry for our clients customers and our culture.

A Little About You

You bring a unique blend of personality and professional expertise to your work inspiring others with your passion and dedication. Your career is a testament to your diverse experiences community involvement and the valuable lessons youve learned along the way. You are more than just your resume; you are a reflection of your achievements the knowledge youve gained and the personal interests that shape who you are.

Position Overview

EDI Analyst II

Job Description Summary:

As part of our continued growth Zelis is seeking an experienced EDI Analyst II to support and optimize healthcare EDI integrations with a primary focus on ANSI XElectronic Remittance Advice (ERA) this role you will troubleshoot complex EDI issues improve integration processes through automation and AI-enabled tools and ensure the accuracy integrity and compliance of healthcare payment data while collaborating with cross-functional teams and external partners.

What Youll Do

• Analyze and troubleshoot complex ANSI X(ERA) transactions identifying processing formatting balancing and compliance issues.
• Perform root cause analysis resolve EDI processing issues and implement preventive solutions.
• Design and maintain EDI integration workflows data mappings technical documentation and testing plans.
• Interpret payer and provider specifications to ensure compliance with HIPAA ANSI X12 and trading partner requirements.
• Generate validate and review EDI files communicating findings and recommendations to internal teams and clients.
• Serve as the technical point of contact for escalated 835 remittance provider payment and clearinghouse issues.
• Partner with internal teams clients vendors and trading partners to resolve integration connectivity and workflow challenges.
• Leverage AI-enabled tools and automation to improve data quality validation reconciliation and operational efficiency.
• Manage multiple priorities document best practices ensure HIPAA compliance and identify process improvement opportunities.
• Mentor junior analysts and stay current with healthcare EDI standards integration technologies and AI advancements.

What Youll Bring to Zelis

• Bachelors degree in Information Systems Healthcare Administration Computer Science or a related field or equivalent experience.
• 57 years of healthcare EDI experience including 35 years supporting HIPAA ANSI X12 835 transactions; experience with 837 834 and 270/271 is a plus.
• Strong understanding of the healthcare claims lifecycle payment processing provider payment posting and reconciliation.
• Experience with EDI validation tools (Edifecs Crystal Validation) ANSI X12 standards data mapping and healthcare integration processes.
• Advanced SQL and data analysis skills; Microsoft SQL Server experience preferred.
• Proficiency with Microsoft Teams Word Excel Notepad and AI tools such as ChatGPT; Jira C# or API experience is a plus.
• Excellent analytical communication troubleshooting and problem-solving skills with the ability to mentor junior analysts and collaborate across technical operational and client-facing teams.

Please note at this time we are unable to proceed with candidates who require visa sponsorship now or in the future.

Location and Workplace Flexibility

Zelis is headquartered in the U.S. with multiple locations across the country and in Hyderabad India. Check out our locations to learn more about our offices. All employee work locations are based on the needs of the position and are determined by the Leadership -office work and activities vary based on work and team objectives in accordance with Company policies.

While location expectations vary by role candidates within approximately 50 miles of a U.S. office are generally preferred to support collaboration when needed. Our hybrid approach is flexible and in-office presence is guided by team and business needs rather than a fixed weekly schedule.

Base Salary Range

At Zelis we are committed to providing fair and equitable compensation packages. The base salary range allows us to make an offer that considers multiple individualized factors including experience education qualifications as well as job-related and industry-related knowledge and skills etc. Base pay is just one part of our Total Rewards package which may also include discretionary bonus plans commissions or other incentives depending on the role.

Zelis full-time associates are eligible for a highly competitive benefits package as well which demonstrates our commitment to our employees health well-being and financial protection. The US-based benefits include a 401k plan with employer match flexible paid time off holidays parental leaves life and disability insurance and health benefits including medical dental vision and prescription drug coverage.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.

We welcome applicants from all backgrounds and encourage you to apply even if you dont meet 100% of the qualifications for the role. We believe in the value of diverse perspectives and experiences and are committed to building an inclusive workplace for all.

Accessibility Support
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process please email .

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities duties and skills from time to time.