Description

You will own the requirements definition and validation for EDI integrations within the healthcare domain.

Responsibilities

• Gather and document requirements for EDI implementations by collaborating with stakeholders, product owners, and technical teams.
• Analyze, define, and validate HIPAA X12 transactions (837, 835, 270/271, 276/277, 278, etc.).
• Create and maintain BRDs, FRDs, user stories, process flows, and use cases.
• Serve as the liaison between business teams, trading partners, and IT during onboarding and integration.
• Support User Acceptance Testing (UAT) planning and execution, including test case creation and defect triage.

Required Skills

• 8+ years of Business Analyst experience, with at least 5+ years focused on healthcare EDI.
• Strong knowledge of HIPAA X12 transactions (837, 835, 270/271, 276/277, 278).
• Experience working with healthcare payers, providers, or clearinghouses.
• Familiarity with EDI tools/platforms such as Edifecs and Foresight.
• Strong analytical and documentation skills (BRD, FRD, user stories, workflows).
• Experience with SQL for data validation and analysis.
• Strong understanding of software development life cycle and Agile methodologies.
• Expertise in developing process flow diagrams, use cases, and functional/technical requirements in the form of user stories.
• Advanced knowledge of BA techniques including process modeling, root cause analysis, and risk assessment.

Preferred Skills

• Experience with Edifecs platform (Specbuilder, Transaction Manager, TPM, etc.).
• Familiarity with claims adjudication systems (Facets, QNXT, Epic, etc.).
• Knowledge of Cloud Data Platforms and APIs.

Key Skills

Education

Any Gradute