Senior EDI Business Analyst
2 weeks ago
SafeRide Health is seeking a Sr. EDI Business Analyst to ensure the accuracy and completeness of healthcare encounter data submissions to CMS (Centers for Medicare & Medicaid Services). This role serves as the key liaison between business, technical, operations, and compliance teams, ensuring our encounter data management processes meet regulatory and client standards.
You'll play a pivotal role in analyzing, validating, and optimizing data pipelines that support our mission of removing barriers to care for underserved populations. This is an opportunity to contribute to healthcare innovation while driving operational excellence and data integrity at scale.
Key Responsibilities- Own end-to-end encounter data management processes to ensure compliance with CMS and state Medicaid guidelines.
- Compile, analyze, and validate encounter submissions to ensure accuracy, completeness, and alignment with Service Level Agreements (SLAs).
- Support audit and regulatory reporting initiatives by developing and maintaining documentation and validation frameworks.
- Develop and maintain processes to extract and transform data from source systems into HIPAA X12 837P format for encounter submissions.
- Collaborate cross-functionally with account management, data, and operations teams to gather requirements, document workflows, and oversee vendor or client deliverables.
- Analyze data to identify trends, anomalies, and root causes, providing actionable insights to optimize workflows and improve ETL efficiency.
- Recommend and implement process improvements that enhance scalability, accuracy, and compliance across encounter data workflows.
- Bachelor's degree or equivalent experience, with 4+ years in healthcare technology, managed care, consulting, or a related field focused on regulatory data exchange.
- Hands-on experience with HIPAA X12 837P Medicaid submissions, including loop and segment structures, and regulatory reporting to CMS or state agencies.
- Understanding of payer operations, claims processing, and encounter lifecycle management.
- Proven ability to manage multiple projects independently, prioritize effectively, and meet tight deadlines.
- Strong analytical, problem-solving, and communication skills.
- Highly self-sufficient and detail-oriented, comfortable in a fast-paced, dynamic environment.
- Strong SQL and Excel skills, with familiarity in data visualization tools such as Tableau, Looker, or QuickSight.
- Client-facing experience working with healthcare payers, providers, or clearinghouses.
- Experience with Edifecs or similar EDI tools.
- Competitive salary and annual bonus opportunities
- Remote with flexible hours
- Comprehensive health, dental, and vision insurance
- 401(k) with company match
- Generous PTO, 10 paid company holidays, and paid parental leave
- Career growth opportunities in a mission-driven organization
SafeRide Health is a technology and services company committed to eliminating transportation barriers to healthcare. By combining our proprietary tech platform with a nationwide network of vetted transportation providers, we empower payers and health systems to deliver smarter, more reliable non-emergency medical transportation.
Our platform supports the nation's largest Medicare Advantage, Medicaid, and provider programsimproving health outcomes and patient experiences at scale.
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