Essential Duties

• Responsible for the implementation of any new client\network or vendor relationship using Electronic Data Interchange
• Build and maintain relationships with Zelis adjudication system partners and other vendors; serve as liaison to bridge gaps between system partners and clients.
• Coordinate with business application, and database administration functions to ensure availability and reliability of EDI systems to meet business demands.
• Perform system configuration, mapping, and management for EDI-based transactions and processes.
• Develop, enhance, and maintain EDI (ANSI-X12) maps for both inbound and outbound transactions.
• Work closely with trading partners to plan, execute, and implement data exchanges to benefit both parties.
• Document scope of work in all stages of implementation; noting customizations, routing rules, etc.
• Work with EDI trading partners to test and implement new file delivery or implement software changes for automation and client success opportunities channels.
• Manage receipt and delivery of test files; advise VP Partner Development of any issues with adjudication system test files. Work with the Implementation Manager and client is there are any issues with client test files.
• Monitor, troubleshoot, and correct EDI transactions.
• Analyze and deliver reports identifying process improvement opportunities.
• Develop and maintain project and system documentation per standard.
• Perform typical business analyst duties such as requirements gathering, solution design, development, and testing to meet business needs.
• Monitor new technologies, techniques, and tools in the EDI space to continue to enhance EDI systems.
• Assist with development of user test plans and execution of those plans in conjunction with internal and external personnel.
• Develop and conduct end user training for EDI systems.
• Drive the adoption of standard work processes, standard application functionality and data standards, as well as the alignment with global corporate policies and IS methodology.
• Acquire and improve skills in EDI and other applications through education and professional organizations.

Education/Experience

• Bachelor's degree in MIS, Business, or related field (or equivalent).
• Five or more years of EDI work experience required.
• Two or more years of SQL Server Management Studio experience required

Knowledge/Skills/Abilities

• Experience implementing, configuring, and maintaining EDI systems.
• Strong experience with ANSI 837, 834,999, 277 EDI formats
• Strong SQL skills, SQL development using Microsoft SQL 2012 and up, development of store procedures, functions, views, triggers
• Ability and desire to created detailed data and mapping requirements.
• Must have HIPAA compliance environment regulations exposure
• Knowledge of EDI standard formats (ANSI X12, EDIFACT, etc.), XML and other EDI translators
• Demonstrable experience using data translation
• Highly motivated self-starter.
• Ability to think strategically and also to implement those strategies.
• Excellent analytical and problem-solving skills.
• Schedule/deadline oriented.
• Excellent verbal and written communication skills.
• Strong interpersonal skills to work effectively with business users and co-workers.
• ETL experience a plus

As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.

Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.

Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All 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 encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.

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, to request the reasonable accommodation request form, please email TalentAcquisition@zelis.com

SCAM ALERT: There is an active nationwide employment scam which is now using Zelis to garner personal information or financial scams. This site is secure, and any applications made here are with our legitimate partner. If you’re contacted by a Zelis Recruiter, please ensure whomever is contacting you truly represents Zelis Healthcare. We will never asked for the exchange of any money or credit card details during the recruitment process. Please be aware of any suspicious email activity from people who could be pretending to be recruiters or senior professionals at Zelis.