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EDI Medical Business Analyst

Roles & Responsibilities

  • 5+ years of IT Operations and Maintenance (OM) experience with ITSM, ITIL, vendor management, and process mapping
  • Extensive experience with EDI transactions (e.g., 837, 835, 270/271, 277CA, 277RFAI, NCPDP) and knowledge of X12/EDIFACT, HIPAA standards, EDI translators, and EDI layouts
  • Experience onboarding and testing EDI with third-party providers; ability to map, test, and troubleshoot EDI; familiarity with tools like Gentran, TLE, RabbitMQ, MuleSoft, IBM B2B Sterling Integrator
  • Healthcare domain expertise; ability to gather business requirements and translate to technical specifications; SAFe/Agile experience; Bachelor's degree in Engineering or related field; certifications such as CSM/CSPO/SAFe preferred

Requirements:

  • Write detailed EDI requirements for Epics/Features/Stories and translate them to technical specifications for the development team; maintain up-to-date EDI user stories
  • Serve as a bridge between business, design, development, and test teams for EDI-related questions and clarifications; gather and sign off on requirements
  • Support integration testing between external systems and EDI providers; test and validate EDI requirements end-to-end
  • Plan and design complex business processes and system modifications; create workflows, EDI maps, and manage EDI connections; provide recommendations to improve business activities

Job description

Overview:

Are you a purpose-driven Medical EDI Business Analyst seeking to join Dreamers, Drivers, and Doers who serve the Veterans that have protected our Freedom?

 

At TISTA, you’ll do meaningful, mission‑driven work that improves lives alongside teammates you trust and leaders who are transparent and supportive. We invest in your learning and internal mobility so you can build a career that keeps advancing. We’re proud to serve and hire Veterans, and we put people first in everything we do.

 

TISTA associates enjoy above Industry Healthcare Benefits, Remote Working Options, Paid Time Off, Training/Certification opportunities, Healthcare Savings Account & Flexible Savings Account, Paid Life Insurance, Short-term & Long-term Disability, 401K Match, Tuition Reimbursement, Employee Assistance Program, Paid Holidays, Military Leave, and much more!

Responsibilities:
  • Write detailed Requirements for EDI related Epics/Features/Stories and transitioning them to technical team
  • Keep the EDI related user stories up to date.
  • Act as a bridge between business, design, development, and test teams for all EDI related questions/clarifications
  • Support integration test efforts between external systems and EDI (third-party providers)
  • Testing/Validating for EDI requirements 
  • Plans and designs complex business processes and system modifications. Provide recommendations to improve and support business activities
  • Gathers business requirements through a variety of techniques such as work sessions, meetings, and interviews
  • Analyzes and documents client complex business requirements and processes; communicates these requirements to appropriate parties and get signoff
  • Provides inputs into developing and modifying systems to meet client needs
  • Coordinates and facilitates meetings with clients to gather and document requirements and explore potential solutions
Qualifications:
  • 5 yrs relevant experience in

    o IT Operations and Maintenance (O&M)

    o Service Supplier/Vendor management

    o IT Service Management (ITSM)

    o ITIL framework 

    o Process mapping

    o Functional Decomposition of IT O&M functions

    o Identify and Assess Direct and Indirect O&M activities

  • Experience mapping and supporting EDI based transactions i.e., 837(I/P/D), 835, 999, 997, 270/271, 277CA, 277RFAI, NCPDP etc
  • Excellent medical domain knowledge and work experience
  • Knowledge of EDI, X12/EDIFACT, HIPPA standards and practices, and EDI translators
  • EDI experience (setup, mapping, testing, processing, troubleshooting)
  • Proficient in EDI layouts (loops, segments, data elements)
  • Perform EDI onboarding and testing with applicable third-party providers
  • Create workflows, process flows, and Manage EDI Maps and Connections
  • Create project plans, test plans, conduct end to end testing/validation
  • Translator tool knowledge and experience e.g Gentran, TLE etc
  • Knowledge and experience with tools such as Rabbit MQ, MuleSoft, IBM B2B Sterling Integrator (nice to have)
  • Working with SQL Server databases
  • Experience in ETL/Data Warehousing skills 
  • Experience in SAFe Agile team environment driving stand up, backlog grooming, and iteration planning
  • Experience with HL7, FHIR, and other healthcare messaging frameworks preferable
  • Experience with data exchange protocols such as FTP, SFTP, AS2 etc..
  • Knowledge of JSON and XML standards preferable
  • Experience in a customer–facing role, including comprehending business needs, solving complex problems, and capturing business requirements to convert them into technical requirements
  • Experience with leading Scrum teams as a Scrum Master and working with developers to translate business needs into user stories
  • Experience working on Federal programs that are of high priority, visibility, and public-facing
  • Experience with Agile delivery programs
  • Must be able to work quickly with a high degree of accuracy with cross-functional teams
  • Able to work under minimal supervision, act independently and exercise an expert level of decision-making capability
  • Excellent writing skills and ability to produce polished written products
  • Demonstrated ability and experience using Microsoft Office Suite including Word, PowerPoint, Excel, Visio, and Access

 

Education

  • Bachelor's Degree (Engineering or a related scientific/technical discipline)
  • Certified Scrum Master, Certified Scrum Product Owner, SAFe and other Agile Certification (nice to have)

Clearance:

  • The ability to pass a Moderate Background Investigation (MBI)
 

Location

  • Remote, USA.

Pay Range:

  • The pay for this position ranges from $55,730 to $73,500.
  • The actual salary offer will carefully consider a wide range of factors, including your skills, qualifications, experience, and location.
  • Also, certain positions are eligible for additional forms of compensation, such as bonuses.
  • TISTA associates are eligible to participate in our comprehensive benefits plan! More information can be found here: https://tistatech.com/working-at-tista/.

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