[Remote] Senior Healthcare EDI X12 Business Systems Analyst/Healthcare EDI X12 PM

Note: The job is a remote job and is open to candidates in USA. Infinite Computer Solutions is a global leader in digital engineering and IT services, seeking a Senior Healthcare EDI X12 Business Systems Analyst/Healthcare EDI X12 PM. The role involves managing EDI implementation projects, ensuring compliance with HIPAA standards, and acting as a liaison between internal teams and external partners.

Responsibilities
• Project Delivery: End-to-end management of EDI implementation, upgrades, and migration projects (e.g., to cloud, Sterling B2B Integrator)
• Stakeholder Management: Acting as the primary liaison between internal business teams, IT, and external trading partners
• Technical Oversight: Overseeing mapping, testing, and transaction flows (ANSI X12, EDIFACT, XML, JSON) and ensuring data security
• Methodology & Governance: Utilizing Agile or Waterfall to define project plans, milestones, and risk mitigation strategies
• Documentation & Reporting: Maintaining mapping specifications and providing regular status updates to leadership

Skills
• Extensive hands-on experience with Healthcare EDI (X12N) standards, including deep understanding of transaction structures, segment loops, code sets, and compliance rules that govern HIPAA-mandated EDI exchanges
• In-depth knowledge of HIPAA/EDI X12 5010 transactions, including but not limited to: 270/271, 276/277, 277CA, 820, 834, 835, 837 (I/P/D), and 999
• Proven ability to interpret, validate, and troubleshoot EDI files end-to-end — including envelope structures, ISA/GS segments, ST/SE loops, and companion guide variations
• Expert-level understanding of EDI concepts, practices, and workflows within the healthcare ecosystem (enrollment, eligibility, claims, remittance, prior authorization, premium billing, etc.)
• Hands-on troubleshooting experience with EDI file processing flows, including identifying translation errors, mapping issues, partner-specific formatting discrepancies, and system integration failures
• Experience with the Edifecs platform, including: SpecBuilder (creating and maintaining implementation guides), Edifecs Mapper (map development and debugging), XEngine / XEServer (validation, translation, and processing rules), TPM (trading partner configuration)
• Ability to debug processing logs, analyze error codes, and tune validation rules
• Proficiency in SQL for data validation, root-cause analysis, and troubleshooting upstream/downstream system issues
• Single point of accountability for up to 20 direct and/or matrixed staff, including sub-contractor(s)
• PMP Certified
• Project Manager with x years of experience
• EDI specific domain - Strong knowledge in EDI environment, upstream and downstream
• Resource should have 12+ Years of experience
• Exposure with QNXT preferred, including understanding of core modules such as claims, enrollment, provider, and benefits configuration
• CEF/QNXT EDI Gateway experience would be preferrable

Company Overview
• Next-Gen Business Technology Platformization™, AI and Product Engineering Services. It was founded in 2001, and is headquartered in Rockville, Maryland, USA, with a workforce of 10001+ employees. Its website is https://www.infinite.com.

Company H1B Sponsorship
• Infinite Computer Solutions has a track record of offering H1B sponsorships, with 563 in 2025, 333 in 2024, 378 in 2023, 316 in 2022, 389 in 2021, 496 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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