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Location: Hybrid Philadelphia, PA (Must be able to work on site Hybrid)
Duration: 6+ month contract
- This role ensures data accuracy, maintains key system interactions, manages complex client file activity, and supports strategic initiatives across enrollment technology platforms. The position also provides leadership to team members, drives process automation, and collaborates cross‑functionally with technical and business stakeholders.
- Ensure the successful transfer of inbound EDI enrollment data, including troubleshooting and resolving data integrity discrepancies.
- Manage EDI file activity for high‑profile and complex client groups (including BPO, Shared Services, and non‑standard configurations).
- Serve as a central point of contact between EDI senders, client teams, Account Management, Customer Experience, BizTalk/.NET teams, and project teams.
- Lead and/or participate in project initiatives involving sprint work, business requirement documentation, system upgrades, and end‑to‑end business checkouts.
- Oversee and manage all Robotic Process Automation (RPA) workflows for the business area.
- Support the Business Systems Analyst with client‑specific EDI enrollment testing and test scenario execution.
- Assist in developing user system documentation, desk‑level procedures, and operational guides.
Support Member Enrollment System functions-including development work, system inquiries, and EDI‑related file activity.
Required
- Strong working knowledge of EDI principles, enrollment workflows, and data integrity practices.
- Understanding of system design and the ability to work across multiple business systems.
- Hands‑on experience with XML, ANSI 834, and HIPAA X12 transactions.
- Practical experience with EDI enrollment validation within HealthRules and the Front Office System, including how both platforms interface with the EDI Portal.
- General EDI/eligibility operations experience is required.
