THE ARCHITECT : Electronic Data Interchange Specialist – Team Lead

The Role:

• EDI is the invisible infrastructure of healthcare billing. As The Architect, you will manage trading partner onboarding, data mapping, HIPAA/ANSI X12 compliance, real-time transmission monitoring, error resolution, integrations, and automation improvements.
• You identify silent failures before they impact operations and ensure claims, eligibility checks, and remittance transactions move accurately and seamlessly across every payer connection.

What You Will Own – Your Responsibilities :

• Trading Partner Onboarding — Configure mappings, validate formats, and ensure HIPAA/ANSI X12 compliance
• EDI Error Handling — Monitor real-time transmissions, identify root causes, and document resolutions
• Data Mapping & Integration — Maintain accurate system and payer data mappings
• Performance Monitoring — Track transaction success rates, error trends, and transmission health
• Regulatory Compliance — Ensure adherence to HIPAA/ANSI X12 and payer standards
• Automation Improvement — Reduce manual EDI tasks through workflow automation

Non-Negotiable Metric :

• 99%
• Percentage of EDI transactions processed successfully without transmission or mapping errors across all trading partners monthly.

The Fight: What You will Fight:

• The unmapped field

• The broken payer configuration

• The failed transmission hidden inside thousands of successful ones

• The unnoticed rejection that delays revenue downstream

No one sees the failure until claims stop moving – Your responsibility is to see it first.

WHO THRIVES HERE : Three Traits We Cannot Teach

• System Thinking — Identify root configuration issues and prevent recurring failures
• Precision in Format — Ensure accurate EDI mappings and error-free transmissions
• Calm Under Pressure — Resolve EDI failures with structured troubleshooting and clear root-cause analysis

THE WWS PERKS :

• Full training in EDI systems and HIPAA/ANSI X12 standards
• Exposure to payer integrations and healthcare transaction workflows
• Clear ownership and performance-driven operations
• Hands-on experience in EDI systems and automation
• Career growth opportunities in healthcare operations
• Culture focused on reliability, accountability, and system performance

Qualifications:

• Experience: 3+ years of experience in healthcare transactions, data mapping or documentation work with team leadership.
• Education: Bachelor’s degree in any discipline.
• Technical Understanding: Strong understanding of EDI workflows, HIPAA/ANSI X12 standards, and healthcare transaction systems.
• Leadership Skills: Experience in handling teams, driving operational performance, and managing issue escalations.
• Analytical Skills: Strong troubleshooting and root-cause analysis abilities.
• Communication: Effective coordination with internal teams, payers, clients, and stakeholders.
• Documentation: Proficient in maintaining clear, structured, and audit-ready documentation.

Contact us on [email protected] / 9047477375
To Apply: https://careers.wonderws.com