Talent.com
EDI Solutions Analyst - Remote

EDI Solutions Analyst - Remote

UnitedHealth GroupEden Prairie, MN, United States
12 hours ago
Job type
  • Full-time
  • Remote
Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Have you been working with Utilization Management systems and / or Claims Payment systems and their associated HIPAA X12 EDI 278 Authorization transactions? Are you looking for an opportunity to expand your experience working with EDI 278 integrations in the health care industry? We have a great opportunity for an individual to lead trading partner integrations from end to end working with our proprietary Medical Management system (MMS) and connecting it to a variety of Claims systems (FACETS, IDX, Xcelys and IKA, just to name a few). The EDI Solutions Analyst ensures that the technical integration between the MMS and Claims systems is seamless to our end users for all Authorization Data using an EDI 278 transaction. Our technical environment includes an Azure cloud-based database solution where we talk to a PostGres SQL databases for our core application database technology along with leveraging Snowflake SQL to interact with our reporting data warehouse for conducting EDI 278 statistical analysis on the health of our EDI 278 integrations as well as conducting deep dive transaction research for troubleshooting integration issues. You will use your existing database SQL skills to broaden your understanding of the required data mapping necessary to stand up the EDI 278 transaction for our trading partners. Can you articulate and interpret business requirements and compare them against the industry standard technical implementation guide of the X12 278 transaction giving trading partners real-world scenario variances of the allowed usage for the specific loop-segment-element of the EDI 278 transaction? If this sounds like what you have been doing and something you want to continue to build upon your existing in-depth knowledge of how the EDI 278 (Authorization / Referral) transaction works in health care, please read on and apply as we have an opening on our team and would like to hear from you about your existing specialized experience in this space.

You'll enjoy the flexibility to work remotely

  • from anywhere within the U.S. as you take on some tough challenges.

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities :

  • Monitor Daily EDI Transaction Processing
  • Troubleshoot and Resolve any EDI processing issues
  • Implementation Team Resource for EDI validation and Testing as required
  • Prepare and update program documentation, job aides, and other artifacts as requested.
  • Process review, data analysis and measurement for various programs related to prior authorizations, claims and member eligibility
  • Preparation of reports as needed by management
  • Identification and communication of processing issues to leadership
  • May involve some interfacing with clients, managed care customers, IT resources and others when needed
  • Assignment of special projects as needed
  • You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications :

  • 2+ years of experience in each of the following :
  • Experience within the healthcare data environment - eligibility, provider, claims, etc

  • Experience with data mapping and workflow documentation
  • EDI Production Support and Maintenance experience including editing and correcting X12 278N transactions for resubmission to Trading Partners.
  • EDI testing and validation experience
  • Healthcare IT experience
  • Experience with SQL (manipulating data and queries) - Relational databases like MySQL, MS SQL, DB2
  • Experience using Microsoft Word (creating and editing documents), Microsoft Outlook (email and calendar), Microsoft Excel (pivot tables, formulas (vlookup, xlookup, match, etc..) and Microsoft Visio (process / data flow diagrams)
  • Healthcare EDI Transaction Knowledge and Expertise
  • Specific EDI X12 ANSI 278 Transaction Expertise
  • Preferred Qualifications :

  • 2+ years of EDI 278 transaction mapping experience
  • Experience working with cloud-based solutions and services
  • Knowledgeable about claims billing practices and process management concepts - this may include knowledge of CPT coding or reimbursement processes, 3rd party provider enrollments, claims submissions, EDI 278 and HIPAA transactions and / or accounts receivables
  • Demonstrated ability to write clear technical and functional specs for authorization data integration services
  • Soft Skills :

  • Solid organization skills and attention to detail
  • Excellent communication skills, both verbal and written, with the ability to interact with various levels of resources internally and externally.
  • Telecommuting Requirements :

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
  • Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

    At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

    UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

    UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

    Create a job alert for this search

    Edi Analyst • Eden Prairie, MN, United States

    Related jobs
    • Promoted
    Sr. FPA Analyst (Remote)

    Sr. FPA Analyst (Remote)

    KLDiscoveryEden Prairie, MN, United States
    Remote
    Full-time
    KLD is looking for a highly motivated finance professional to play a key role in the company's strategic growth plan.Analyst FPA role will be responsible for the timely and accurate reporting of cu...Show moreLast updated: 30+ days ago
    • Promoted
    Survey Taker : Earn up to $25 per survey (Remote)

    Survey Taker : Earn up to $25 per survey (Remote)

    Earn HausOtsego, MN, United States
    Remote
    Full-time +1
    Looking for people to participate in taking online surveys for Fortune 500 brands.All you need to do is complete online surveys by sharing your opinion. You will help influence brand decisions on se...Show moreLast updated: 30+ days ago
    • Promoted
    Classroom Aide - Immediate Start

    Classroom Aide - Immediate Start

    Zen EducateHamel, MN, United States
    Full-time
    Get Set for the 2025-2026 School Year!.Step into full-time paraprofessional and classroom aide roles and support students with special needs in real classroom settings. You'll grow your skills, gain...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Commercial Banking Analyst - AI Trainer

    Remote Commercial Banking Analyst - AI Trainer

    Data AnnotationWoodbury, Minnesota
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Senior Financial Analyst - AI Trainer

    Remote Senior Financial Analyst - AI Trainer

    Data AnnotationEagan, Minnesota
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...Show moreLast updated: 30+ days ago
    • Promoted
    Sr Actuarial Analyst ALDP - Remote - Minnetonka, MN preferred

    Sr Actuarial Analyst ALDP - Remote - Minnetonka, MN preferred

    UnitedHealthcareEden Prairie, MN, US
    Remote
    Full-time
    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people ...Show moreLast updated: 3 days ago
    • Promoted
    eDiscovery Analyst

    eDiscovery Analyst

    Taft Stettinius & Hollister LLPMinneapolis, MN, United States
    Full-time
    Taft is seeking an eDiscovery Analyst to serve our eDiscovery Services team in Taft's Chicago, Cincinnati, Cleveland, Columbus, Dayton, Denver, Detroit, Indianapolis or Minneapolis office.We are se...Show moreLast updated: 30+ days ago
    • Promoted
    Tax Expert - Local

    Tax Expert - Local

    IntuitCedar, MN, United States
    Full-time
    Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...Show moreLast updated: 25 days ago
    • Promoted
    RPA Business Analyst Co-Op - Spring 2026

    RPA Business Analyst Co-Op - Spring 2026

    EntegrisChaska, MN, United States
    Full-time
    RPA Business Analyst Co-Op - Spring 2026.RPA Business Analyst Co-Op - Spring 2026 Here at Entegris, we use advanced science to enable technologies that transform the world, and we are seeking emplo...Show moreLast updated: 24 days ago
    • Promoted
    Leasing Specialist

    Leasing Specialist

    Compeer FinancialLakeville, MN, United States
    Full-time
    Compeer Financial is a member-owned cooperative located in Illinois, Minnesota and Wisconsin.We bring together team members with a variety of backgrounds and experiences to help provide financial s...Show moreLast updated: 2 days ago
    • Promoted
    Tax Expert - Onsite

    Tax Expert - Onsite

    IntuitCorcoran, MN, United States
    Full-time
    Overview Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United Sta...Show moreLast updated: 4 days ago
    • Promoted
    • New!
    Senior Business Analyst (Remote - MN)

    Senior Business Analyst (Remote - MN)

    First Citizens BankMinneapolis, MN, US
    Remote
    Full-time
    This is a remote role that may only be hired in the following locations : MN.This is a hybrid role in the first quarter, then the role will shift to remote. We are seeking a strategic and detail-orie...Show moreLast updated: 11 hours ago
    • Promoted
    Adobe Analytics - Senior Digital Analyst - Remote

    Adobe Analytics - Senior Digital Analyst - Remote

    UnitedHealth GroupEden Prairie, MN, United States
    Remote
    Full-time
    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...Show moreLast updated: 30+ days ago
    • Promoted
    Tax Expert - 2+ Yrs Paid Tax Experience Required

    Tax Expert - 2+ Yrs Paid Tax Experience Required

    IntuitJordan, MN, United States
    Full-time
    Overview Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United St...Show moreLast updated: 10 days ago
    • Promoted
    Remote Financial Analyst - AI Trainer

    Remote Financial Analyst - AI Trainer

    Data AnnotationCoon Rapids, Minnesota
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the q...Show moreLast updated: 30+ days ago
    • Promoted
    Tax Expert - Onsite - 2+ Yrs Paid Tax Experience Required

    Tax Expert - Onsite - 2+ Yrs Paid Tax Experience Required

    IntuitCedar, MN, United States
    Full-time
    Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...Show moreLast updated: 2 days ago
    • Promoted
    Tax Expert

    Tax Expert

    IntuitCedar, MN, US
    Full-time
    Overview Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United Sta...Show moreLast updated: 5 days ago
    • Promoted
    • New!
    Logistics Support Associate

    Logistics Support Associate

    FedExRogers, MN, United States
    Full-time +1
    Come for a job and stay for a career! Federal Express Corporation (FEC) is part of the rapidly growing warehouse and transportation sector that helps keep America, and our economy, moving.Be part o...Show moreLast updated: 8 hours ago