Healthcare EDI Business Analyst - 270/271 Eligibility & Benefits

Job Title: Healthcare EDI Business Analyst – 270/271 Eligibility & Benefits

📌 Summary

The Healthcare EDI Business Analyst is responsible for analyzing ANSI X12 270/271 eligibility and benefits transactions, defining business and technical requirements, and designing strategies to parse and present coverage, copay, coinsurance, deductible, and out-of-pocket data to end users. This role bridges product, revenue cycle/eligibility operations, and engineering to ensure accurate, compliant, and user-friendly eligibility verification workflows.

🛠 Key Responsibilities

• Own the end-to-end strategy for eligibility data presentation, including EB segment prioritization and simplification of complex benefit structures.
• Define the canonical internal data model for eligibility and benefit information across products and workflows.
• Lead discovery sessions with revenue cycle, registration, and clinical s...