EDI Specialist

Remote Full-time
Job Title: EDI Specialist
Job Type: Full-time
Yearly Salary: $65,000-$85,000 (DOE)
Work Location: Remote
Position Overview:
We are a growing third party benefits administrator dedicated to helping companies manage their employee health benefits. In this role, you will be the primary technical lead for our data exchange ecosystem, ensuring that enrollment and contribution data for FSA, HSA, HRA, and COBRA plans flow seamlessly between employers, carriers, and our administration platform. As part of a small, collaborative team, this role requires versatility and ownership across a broad range of responsibilities from high-level partner onboarding to detailed troubleshooting of daily data file transmissions.
Key Responsibilities:
Benefits Enrollment Management: Configure, validate, and monitor EDI 834 (Enrollment and Maintenance) transactions to ensure accurate processing of new hires, qualifying life events, and terminations across all benefit plans.
Partner Onboarding & Integration: Lead the technical implementation and onboarding of new employer groups and insurance carriers, establishing secure data exchange connections via SFTP, AS2, or other approved protocols.
Compliance & HIPAA Oversight: Ensure all data exchanges meet strict HIPAA security standards to protect Protected Health Information (PHI).
Data Mapping & Transformation: Develop, test, and maintain EDI maps and transformation rules to translate incoming employer and payroll data into standardized system formats, ensuring data integrity and consistency.
Troubleshooting & Support: Proactively identify and resolve file rejections or data mismatches before they impact employee access to their health funds.
Cross-Functional Collaboration: Collaborate closely with Account Management, Claims, and Operations teams to support a high-quality client experience and ensure accurate, timely data flow across systems.

Key Qualifications:
Bachelor’s degree in Information Technology, Computer Science, or a related field.
3+ years in EDI, specifically within healthcare or benefits administration
Knowledge of health benefits (HSA, FSA, HRA, COBRA) and the life events that trigger data changes.
A self-starter comfortable in a small-business environment where you own the process from start to finish.
Strong mastery of ANSI X12 standards, specifically 834 (Enrollment) and ideally 820 (Premium Payments).
Hands-on experience with EDI translation tools and SQL for data validation.
About Us:
Rocky Mountain Reserve provides employee benefits to other companies as a service. The benefits we provide to our clients are FSA, HSA, and COBRA administration. Our mission is to enable employees to save money for needed healthcare costs through these benefits. Providing outstanding customer service is paramount to that mission. We strive to make the world of health benefits easier to understand and simpler to navigate.
At Rocky Mountain Reserve our customer service team is the backbone of our company! You will play an integral role in the success and growth of our company and the reputation we have with our clients. Our Client Services Team is responsible for assisting participants via inbound calls, emails, and chats.
We pride ourselves on our team's professionalism and dedication to excellence. As we continue to grow, we are looking for a dynamic and experienced Customer Service Manager to join our team and contribute to our mission of delivering exceptional customer service.
Benefits:
Health/Dental/Vision Coverage
401k with employer match
Generous PTO & Paid Holidays
A Monday-Friday Schedule (No nights or weekends)
Opportunity for growth and development.
The chance to be a part of a growing company that values customer service
Join us in delivering exceptional service and support to our participants and clients. We look forward to reviewing your application.

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