Eligibility EDI Analyst II

Get To Know Us!

WebTPA, a GuideWell Company, is a healthcare third-party benefit administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans.

What is your impact?

The EDI Analyst II is responsible for maintaining and optimizing EDI processes, working with trading partners, and resolving technical issues related to EDI transactions. This position requires solid knowledge of EDI standards and protocols, as well as the ability to collaborate with teams to improve the efficiency of data exchange. The EDI Analyst II provides ongoing support and troubleshooting of EDI integrations and contributes to the development of new EDI projects.

Position Details:

In office required at 6535 SH-161 S, Irving Texas 75039

What Will You Be Doing:

• Monitor, maintain, and troubleshoot existing EDI systems to ensure transactions are accurate, complete, and delivered on time.
• Investigate and resolve errors, exceptions, and failures in EDI transactions, including reprocessing failed transactions, as necessary.
• Facilitate onboarding and setup for new trading partners, ensuring all technical and business requirements are achieved.
• Troubleshoot mapping and translation errors, resolve discrepancies, and works with trading partners and internal teams to resolve problems and escalate issues to management as appropriate.
• Develop and maintain strong working relationships with internal teams such as IT, Group Configuration, Account Management and Finance to align EDI processes with business needs.
• Assist in EDI-related projects, such as data analysis to identify trends or inconsistencies, new partner integration, system upgrades, or migrations through implementation, testing and post-production support phases to ensure operational efficiency.
• Provide support to internal teams for EDI-related questions and troubleshooting.
• Document EDI processes, transaction flows and system configuration.
• Actively participate and interact with customers to understand business needs, identify the best solution, and assist IT to architect the processes to meet the needs.
• Supports Inbound file(s) and Open Enrollment testing, processing, and reporting as needed.

What You Must Have:

• 3+ years related work experience with EDI systems, including implementation, mapping, and troubleshooting
• Related Bachelor's degree or additional related equivalent work experience
• Strong data analytics and problem-solving skills.
• Proficiency in EDI mapping and translation tools within the health insurance administration industry.
• Ability to manage multiple projects and priorities in a fast-paced environment.
• Advanced knowledge with Microsoft Word, Excel, and Access.
• Comfortable working and communicating across operational areas and working in cross-functional teams.
• Maintain confidentiality and observe HIPAA and PHI requirements.
• Ability to prioritize or seek information on how to best prioritize projects.

What We Prefer:

• Experience with SQL, XML and other relevant programming languages.
• Familiarity with HRIS and their integration with EDI processes.
• Must be a self-starter with the ability to identify problems/issues and offer workable solutions.
• Ability to effectively communicate with clients and executives in a confident manner.

What We Can Offer YOU!

To support your wellbeing, comprehensive benefits are offered. As a WebTPA employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance
• Life insurance, Short- and long-term disability programs
• Leave programs to support personal circumstances.
• 401(k) includes employer contribution match
• Paid time off, volunteer time off, and 11 holidays
• Additional voluntary benefits options avaliable
• Comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for interns and part-time employees may differ.

General Physical Demands

Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can perform at their best in pursuit of our mission. All qualified applicants will receive consideration for employment.