Healthcare Eligibility and Coverage, EDI Analyst (Remote)

Experian is a global data and technology company, powering opportunities for people and businesses around the world. We help to redefine lending practices, uncover and prevent fraud, simplify healthcare, create digital marketing solutions, and gain deeper insights into the automotive market, all using our unique combination of data, analytics and software. We also assist millions of people to realise their financial goals and help them to save time and money.

We operate across a range of markets, from financial services to healthcare, automotive, agrifinance, insurance, and many more industry segments.

We invest in people and new advanced technologies to unlock the power of data and to innovate. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 23,300 people across 32 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com.

As the EDI and Healthcare Insurance Coverage Analyst, you will manage electronic data interchange (EDI) processes and ensure accurate healthcare insurance coverage verification and maintenance. You will report to Experian Health and manage new product development and operational efficiencies, by streamlining data exchange between internal systems and external partners, and by ensuring compliance with insurance policies and regulatory requirements.

EDI Responsibilities:

• Monitor, troubleshoot, and maintain EDI transactions (e.g., 837, 835, 270/271, 276/277)
• Collaborate with IT and external vendors to resolve EDI transmission issues
• Ensure timely and accurate data exchange between systems and trading partners
• Develop and maintain documentation for EDI processes and workflows
• Analyze EDI data for discrepancies and implement corrective actions

Insurance Discovery Responsibilities:

• Assist in the design and management of insurance coverage verification and insurance discovery technology using automated tools and manual processes
• Maintain accurate insurance information in internal systems
• Work with payers to resolve coverage issues and discrepancies
• Assist in the development of policies and procedures related to insurance verification
• Support audits and compliance initiatives related to insurance coverage

Cross-Functional Collaboration:

• Partner with Revenue Cycle, IT, and Compliance teams to ensure data integrity and operational alignment
• Provide training and support to staff on EDI and insurance coverage processes

• Bachelor's degree in Computer Sciences, Healthcare Administration, Information Systems, Business, or related field
• 3+ years' experience in healthcare EDI operations with an emphasis on eligibility and insurance discovery required
• 3+ years' experience with HIPAA data and associated transaction sets and payer requirements required
• 2+ years' experience with clearinghouses, payer EDI, and healthcare management systems (e.g., Epic, Cerner, or similar) required
• 3+ years' experience with EDI formats and standards (X12, HL7) required
• 2+ years' familiarity with healthcare billing and coding practices required

Benefits/Perks:

• Great compensation package and bonus plan
• Core benefits including medical, dental, vision, and matching 401K
• Flexible work environment, ability to work remote
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays
• Explore all our exciting benefits here: https://yourexperianbenefits.com/cand-index.html

At Experian, our people and culture set us apart. We're deeply committed to creating an environment where everyone feels they belong and can excel. From inclusion and authenticity to work/life balance, development, wellness, collaboration, and recognition, we focus on what truly matters. Our people-first approach has earned us global recognition: World's Best Workplaces™ 2024 (Fortune Top 25), Great Place To Work™ 2025 in 26 countries, and Glassdoor Best Places to Work 2024, among others.

Want to see what life at Experian is really like? Explore Experian Life on social or visit our careers site.

Our compensation reflects the cost of labor across several U.S. geographic markets. The base pay range for this position is listed above. Within this range, individual pay is determined by work location and additional factors such as job-related skills, experience, and education. You will be also eligible for a variable pay opportunity.

Experian is proud to be an Equal Opportunity Employer for all groups protected under applicable federal, state and local law, including protected veterans and individuals with disabilities. Innovation is an important part of Experian's DNA and practices, and our inclusive workforce allows everyone to succeed and bring their whole self to work. If you have a disability or special need that requires accommodation, please let us know at the earliest opportunity.

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This is a remote position.