Healthcare EDI Analyst

@ Cobalt Benefits Group LLC

About Us

Join our team at Cobalt Benefits Group and help shape the future of self-funded healthcare benefits. We’re a fast-growing Third-Party Administrator (TPA) delivering customized employee benefit solutions with integrity, respect, and innovation.

Position: Healthcare EDI Analyst

As an EDI Analyst I, you’ll play a critical role ensuring the accuracy and reliability of our enrollment and claims data, supporting clients, members, and internal teams with precision and care.

Job Summary

The Healthcare EDI Analyst provides full lifecycle support for electronic data interchange (EDI) processes including file setup, testing, daily processing, and issue resolution. You will work closely with health plans, clients, and internal teams to ensure timely, accurate, and compliant transactions, while also serving as a subject-matter expert for enrollment and claims operations.

Key Responsibilities

• Manage EDI file processing, validation, and reconciliation for client and carrier data.
• Review and action enrollment and claim-related reports to maintain data integrity.
• Partner with health plans and clients, interfacing with technical and non-technical contacts.
• Produce and test EDI files ensuring all requirements are met before production.
• Provide analysis, troubleshooting, and guidance on complex EDI transfers.
• Monitor and improve EDI submission rates and data quality across systems.
• Act as backup for EDI teammates to ensure coverage and continuity.
• Participate in projects and process improvements as assigned by management.

Requirements

Qualifications: Bachelor’s degree in Computer Science, Healthcare Management, or related field; OR 4+ years of relevant work experience. 2–3 years hands-on experience in a healthcare EDI role, preferably with a TPA, payer, or provider. Working knowledge of HIPAA EDI X12 transactions (834, 837, 270/271, 276/277, 999/TA1), proficiency with SQL, Visual Studio, and/or ETL best practices, and strong analytical and troubleshooting skills.

Personal Attributes

Excellent communication, detail-oriented, collaborative, self-motivated, and well-organized with effective time management.

Work Environment & Physical Demands

Remote work available or hybrid attendance in Exeter, NH or South Burlington, VT. Requires a dedicated, organized home office workspace and comfort with virtual meetings.

Benefits

After a brief waiting period, enjoy competitive medical, dental, and vision insurance, employer contributions to HSA, employer-paid life, AD&D, short-term and long-term disability, flexible spending accounts, 401(k) with match, paid holidays, vacation, sick time, volunteer day, tuition reimbursement, health & wellness reimbursement, and engaging company events.

Key skills/competency

• EDI
• Healthcare
• Enrollment
• Claims
• SQL
• Visual Studio
• ETL
• HIPAA
• Troubleshooting
• Data Validation