EDI Operations Manager - Benefits Administration

We are seeking an experienced and strategic EDI Operations Manager to lead the implementation, oversight, and continuous improvement of our electronic data interchange (EDI) processes within the benefits administration space. This role is pivotal in managing a team of EDI Analysts and ensuring high-quality, accurate, and timely data exchanges between our internal systems, external carriers, and broker partners using Selerix BenSelect.

As a leader in the Benefits Technology department, you will work closely with internal departments, external brokers, and benefits carriers to manage file feeds, troubleshoot complex issues, and guide the team through key milestones including open enrollment, onboarding, and system upgrades.

This role is critical to ensure ongoing scalability, quality, and compliance in our benefits data exchange processes. With growing client demand and increasing carrier file complexity, a dedicated manager is needed to lead the team, optimize file operations, and serve as the key point of accountability for internal and external stakeholders.

Essential Duties and Responsibilities:

· Lead, mentor, and develop a team of EDI Analysts responsible for day-to-day operations of benefits data exchanges.

· Oversee all aspects of EDI file implementation, testing, maintenance, and monitoring using Selerix.

· Serve as the escalation point for complex EDI mapping and transmission issues across group health, dental, vision, and ancillary products.

· Develop and maintain SOPs, file specifications, carrier requirements, and internal documentation.

· Partner with internal teams (Client Services, Account Management, Sales, and IT) and external stakeholders (brokers and carriers) to support data exchange needs, troubleshoot issues, and ensure alignment.

· Establish performance metrics, quality assurance protocols, and audit controls to ensure timely and accurate file processing.

· Support regulatory compliance activities related to HIPAA through accurate data management and secure transmission practices.

· Lead project initiatives for onboarding new clients or carriers, open enrollment file readiness, and platform enhancements.

· Provide regular reporting on department metrics, operational risks, and opportunities for process improvement.

· Conduct regular team meetings, performance reviews, and training sessions to ensure continuous growth and consistency.

· Oversee the configuration, maintenance, and optimization of EDI file feeds within Selerix BenSelect.

· Participate in planning and execution of new client implementations, open enrollment initiatives, and system integrations.

· Serve as the escalation point for complex data mapping, transmission failures, and exception handling.

· Implement quality control practices to minimize data discrepancies and transmission errors.

· Monitor and report on transmission logs, audit files, and reconciliation reports.

· Provide leadership with regular updates on performance metrics, compliance status, and system efficiency.

Qualifications

Required

• 7+ years of experience in EDI analysis/administration in the insurance or employee benefits sector.
• 4+ years of management or team lead experience, preferably in a technology or      operations function.
• Deep knowledge of Selerix BenSelect, ANSI 834 files, and      benefits-related EDI standards.
• Strong leadership, communication, and problem-solving skills.
• Proven ability to collaborate cross-functionally with both technical and non-technical stakeholders.
• Advanced Excel proficiency: ability to audit and reconcile data quickly and accurately.

Preferred Prior experience working directly with insurance brokers and carrier partners.

• Familiarity with ACA reporting, COBRA processes, and enrollment lifecycle management.
• Project management or systems implementation experience is a plus.

 
Education: 

• Bachelors Degree preferred but not required

Attendance Requirements:

· Remote role 

· Daily attendance is required during normal business working hours

· In-person attendance is occasionally required for company, client and/or team meetings outside of the normal schedule.

· The Company reserves the right to request in-person attendance at the Company’s worksite at any time. The Company also reserves the right to make full-time attendance at the Company’s worksite an essential job function for this position if attendance becomes necessary to increase productivity, to develop teamwork, to conduct training, to better address customer needs, or to accomplish any other valid business goal. If full-time attendance requirements for this position change materially, the Company will provide thirty (30) days’ prior notice of the change.

Position Type/Expected Hours of Work:

· This is a full-time position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5 p.m.

· Occasional evening and weekend work may be required as job duties demand.

· Core business hours are 8:00 a.m. to 5:00 p.m. but the employees’ schedules are at the discretion of the supervisor and dependent on the needs of the business.

Travel:

· Travel is primarily local during the business day, although some out of area and overnight travel may be expected

Physical Abilities Required for this Job:

The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform essential functions.

· While performing the duties of this job this individual is frequently required to stand, walk, sit, talk, hear, use their hands and fingers (manual dexterity), use a telephone, and occasionally lift and /or move up to twenty-five pounds. 

· Specific vision abilities required by this position include, close vision, and the ability to adjust focus.

Mental Abilities Required for this Job:

· The ability to solve problems, make decisions, supervise others, interpret data, organize information, written and oral communication and read/write.

· Understands sensitivity of customer data and demonstrates the ability to protect both customer and business information.

· Ability to talk with customers in emotionally challenging situations to address their anxiety and resolve their requests within the limits of the policy.

NOTE: This job description in no way states or implies that these are the only duties to be performed by the employee(s) of this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the employee(s) will possess the skills aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an at will relationship.

The company is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.