[Remote] Enrollment Data Analyst

Note: The job is a remote job and is open to candidates in USA. Evry Health is on a mission to bring humanity to health insurance, and they are seeking a detail-oriented Enrollment Data Analyst to support the accuracy and integrity of member enrollment data across their health plan systems. This role involves managing the lifecycle of enrollment data, ensuring compliance with standards, and collaborating with various teams to resolve data issues.ResponsibilitiesConfigure, monitor, and troubleshoot inbound and outbound HIPAA 834 (Benefit Enrollment and Maintenance) transaction files with trading partners, employers, and TPAsValidate 834 file structures for compliance with X12 5010 standards, identifying and resolving segment errors, loop discrepancies, and rejected transactionsCoordinate with trading partners to resolve enrollment exchange issues and ensure timely, accurate file transmissionPerform systematic validation of member enrollment records against source documents, 834 transactions, and plan eligibility rulesIdentify data anomalies, duplicate records, coverage gaps, and demographic inconsistenciesExecute data quality audits on a scheduled and ad-hoc basis, documenting findings and remediation stepsEnsure enrollment data aligns with plan effective dates, benefit periods, and group contract termsAccurately enter and update member demographic, eligibility, and coverage data across the web UI enrollment portal and the claims processing systemProcess member adds, terminations, changes, and reinstatements in a timely manner in compliance with CMS and ACA guidelinesMaintain supporting documentation for all manual data changes per audit and compliance standardsLead targeted data cleanup projects to address backlogs, legacy migration issues, and discrepancies identified through audits or operational escalationsWrite and execute SQL queries against enrollment and member databases to identify, extract, and correct data issuesCollaborate with the engineering team on bulk update scripts and data remediation workflowsPartner with engineering, claims, and population health teams to surface enrollment data issues affecting downstream claim adjudication, reporting, and care management workflowsSupport compliance and reporting requirements including ACA 1095-B and CMS enrollment submissionsCommunicate enrollment discrepancies and resolution status to internal stakeholders and external partnersSkills2+ years of experience in health plan enrollment operations, managed care, or EDI data processingHands-on experience with HIPAA 834 transaction processing and X12 EDI standardsProficiency with SQL-- able to write queries to retrieve, validate, and correct enrollment data directly against relational databasesExperience working within claims administration systems (e.g., Plexis QC, QNXT, TriZetto, HealthEdge, or similar)Strong attention to detail with a proven ability to manage high volumes of data accuratelyFamiliarity with ACA eligibility and enrollment rules, CMS guidelines, and HIPAA data privacyExperience with web-based enrollment portals or member engagement UIsUnderstanding of downstream impacts of enrollment data on claims adjudication and provider rostersExposure to EDI mapping tools or translation software (e.g., Edifects, BizTalk, or Claritev)Familiarity with population health platforms or care management systemsExperience supporting IRS Form 1095 or CMS risk adjustment data submissionsCompany OverviewEvry Health makes healthcare affordable and high quality again by providing expanded benefits at an affordable price. It is a sub-organization of Globe Life. It was founded in 2017, and is headquartered in Mountain View, California, USA, with a workforce of 51-200 employees. Its website is http://www.evryhealth.com.