EDI Specialist

Judge Group, Inc. Logo
Judge Group, Inc.
Philadelphia, PENNSYLVANIA, United States
  • Logistics
  • Applications have closed

Location: Philadelphia, PA

Salary: $30.00 USD Hourly – $31.00 USD Hourly

Description: Our client is currently seeking a EDI Specialist- Philadelphia, PA

W2 – EDI Specialist-Philadelphia-Hybrid

Philadelphia, PA 19103

Role Summary

This position requires strong expertise in EDI Portal management and inbound EDI enrollment file activity , with responsibility for ensuring successful data transfers, troubleshooting integrity issues, and supporting complex client business processes. The role also involves direct client/team interaction , project participation , and robotic process automation (RPA) oversight .

Key Duties & Requirements

  • Manage inbound EDI enrollment file activity and troubleshoot/reconcile data integrity issues.
  • Handle EDI file activity for high-profile/complex client business (BPO, Shared Services, non-standard).
  • Serve as direct contact between EDI senders, clients, Account Management, Customer Experience, BizTalk/.Net, and project teams.
  • Lead/participate in project meetings, sprint work, documentation, system upgrades, and business check-outs.
  • Manage robotic process automation (RPA) work for the business area.
  • Support Business Systems Analyst with client-specific EDI enrollment testing.

Additional Responsibilities

  • Develop user system documentation and desk-level procedures.
  • Manage daily team inventory activity; provide support/training/direction to Eligibility Specialists.
  • Participate in Enrollment Resolver Group for issue resolution.
  • Organize/disperse team project work.
  • Assist with manual enrollment processing across all lines of business.
  • Support Member Enrollment System platform (development, inquiries, EDI file activity).
  • Meet departmental quality and production standards.
  • Perform other duties as assigned by leadership.

Qualifications

  • Ability to work with multiple business systems; general understanding of system design.
  • Proficiency in Microsoft Office and project management tools.
  • Strong oral and written communication skills.
  • Detail-oriented with understanding of corporate business systems.
  • Ability to work independently and investigate/test/present findings.
  • Technical writing skills.
  • Related enrollment experience in Health Rules system platform; understanding of Front Office System and EDI Portal interaction.

Education & Experience

  • Bachelor’s degree in Business Administration, MIS, Computer Science, or equivalent healthcare/technology experience.
  • Knowledge of XML/ANSI 834 / HIPAA X12 transactions beneficial.
  • In lieu of degree: 2-3 years proven EDI/eligibility experience.
  • Strong communication and analytical skills required.

Scope

  • Working knowledge and experience in discipline.
  • Builds knowledge of organization, processes, and customers.
  • Performs straightforward assignments using prescribed guidelines/policies.
  • Receives moderate guidance/direction from senior roles

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