Healthcare EDI Claims Analyst

Healthcare EDI Claims Analyst

Location: Hybrid – Columbia/Baltimore, MD (2-3 days onsite per month)Duration: 12-Month Contract-to-HirePay Rate: $52.96/hour W2 (No PTO)

About the Role

We are seeking a Healthcare EDI Claims Analyst to support healthcare claims processing operations. This role focuses on investigating claims issues, resolving incident tickets, analyzing EDI transactions, and coordinating with internal teams and health plans to ensure successful claims processing.

This is an operational support and claims analysis positionnot a software development, production support, or monitoring role.

Responsibilities

• Investigate and resolve healthcare claims processing issues and incident tickets.
• Analyze EDI 837 claim transactions, XML files, and claim processing errors.
• Research transaction rejections, data issues, and claim failures.
• Run SQL queries to support claims analysis and troubleshooting.
• Partner with internal teams and external health plans/payers to resolve claims-related issues.
• Support claims adjudication and vouchering processes.
• Document incidents, resolutions, and support procedures.
• Identify opportunities to improve claims processing workflows and efficiency.

Required Qualifications

• 5+ years of healthcare claims processing experience.
• Experience with EDI 837 healthcare claim transactions.
• Experience investigating claims processing errors and transaction failures.
• Incident/ticket management experience.
• Basic SQL skills for querying and analyzing data.
• Experience working with healthcare payers, health plans, or insurance organizations.
• Strong analytical, troubleshooting, and communication skills.

Preferred Qualifications

• EDI 835 transaction experience.
• ServiceNow experience.
• Claims adjudication experience.
• BCBS or other healthcare payer experience.

Ideal Background

Candidates with experience in the following roles are encouraged to apply:

• Healthcare EDI Claims Analyst
• EDI Analyst
• EDI Support Analyst
• Healthcare Claims Analyst
• Claims Systems Analyst
• Claims Operations Analyst

What We're Looking For

A healthcare claims professional who enjoys investigating issues, resolving claims-related incidents, working with EDI transactions, and collaborating across teams to drive successful outcomes. This is a hands-on role focused on claims operations and issue resolution rather than software development.

Apply today to join a team supporting critical healthcare claims processing operations.