Description

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth.

Be part of a team that makes a real difference.

We are seeking an experienced and detail-oriented EDI Business Systems Analyst to join our dynamic healthcare IT team. In this role, you will be a critical liaison between our business stakeholders and technical teams, translating complex business needs into detailed technical specifications. You will apply your deep knowledge of medical claims processing and the ANSI 837 transaction set to create precise EDI mapping documents, ensuring the seamless and accurate exchange of data with our partners.

Responsibilities

• Lead requirements gathering sessions with internal and external stakeholders to define system and process enhancements.
• Create, maintain, and own detailed EDI mapping documents, with a strong focus on the ANSI 837 healthcare claim transaction.
• Analyze existing workflows and data exchange processes to identify and recommend opportunities for optimization.
• Develop comprehensive business requirements documents (BRDs) and functional specifications.
• Serve as a subject matter expert (SME) on medical billing, claims data, and EDI transaction logic for the development team.
• Design and document workflows that support the EDI development and implementation lifecycle.
• Develop robust test scenarios and collaborate with the QA team to validate that solutions meet business requirements.
• Troubleshoot and perform root-cause analysis on EDI processing issues.
• Act as a key resource for project managers, providing clear updates and insights on project activities.

• 2+ years of experience as a Business Analyst, Systems Analyst, or in a similar role.
• Proven experience with ANSI X12 EDI standards, specifically the 837 (Claim/Encounter) transaction set.
• Solid understanding of the U.S. healthcare industry, including medical billing and claims processing workflows.
• Demonstrated ability to create detailed, clear, and accurate functional specifications and EDI mapping documents.
• Strong analytical, problem-solving, and critical-thinking skills.
• Excellent written and verbal communication skills, with the ability to bridge the gap between technical and non-technical stakeholders.

Preferred:

• Bachelor's degree in information systems, Business, or a related field.
• Experience with other healthcare transactions (e.g., 835, 270/271, 277).
• Experience with SQL and APIs (e.g., REST,SOAP) for data integration.
• Familiarity with various SDLC development methodologies (e.g., Agile, Waterfall).

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