Healthcare EDI Analyst bei Cobalt Benefits Group LLC

Description

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) dedicated to delivering customized employee benefit solutions with integrity, respect, and innovation. As an EDI Analyst I, you’ll play a critical role in ensuring the accuracy and reliability of our enrollment and claims data — supporting clients, members, and internal teams with precision and care.

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Job Summary

The EDI Analyst I provides full lifecycle support for electronic data interchange (EDI) processes, including file setup, testing, daily processing, and issue resolution. This role works closely with health plans, clients, and internal teams to ensure timely, accurate, and compliant transactions. The EDI Analyst also serves as a subject-matter resource for enrollment and claims operations, identifying process improvements and supporting enhancements to maximize efficiency and data quality.

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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 both technical and non-technical contacts.

• Produce and test EDI files, ensuring all requirements are met prior to production.

• Provide analysis, troubleshooting, and guidance on complex EDI transfers.

• Monitor and improve EDI submission rates and data quality across systems.

• Act as a backup for EDI teammates to ensure coverage and continuity.

• Participate in projects and process improvements as assigned by management.

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Requirements

Qualifications

• Bachelor’s degree in Computer Science, Healthcare Management, or related field; OR 4+ years of relevant work experience.

• 2–3 years of hands-on experience in a healthcare EDI role, preferably with a TPA, payer, or provider.

• Working knowledge of HIPAA EDI X12 transactions including 834, 837, 270/271, 276/277, and 999/TA1.

• Proficiency with SQL, Visual Studio, and/or ETL best practices.

• Strong analytical, troubleshooting, and report generation skills.

• Ability to work independently and drive resolution of complex EDI file issues with minimal direction.

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Personal Attributes

• Strong verbal and written communication skills; able to translate technical concepts for non-technical stakeholders.

• Detail-oriented with a commitment to accuracy and confidentiality.

• Collaborative team player who thrives in a fast-paced environment.

• Self-motivated, adaptable, and solution-focused.

• Effective organizational and time management skills.

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Work Environment & Physical Demands

• Remote work or the option of hybrid attendance in Exeter, NH or South Burlington, VT.

• Requires a dedicated, organized home office workspace.

• Prolonged periods of sitting and computer use may be required.

• Regular use of a computer, keyboard, and mouse; reasonable accommodations will be provided upon request.

• Comfort with being on camera for virtual meetings (e.g., Microsoft Teams).

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Benefits

After a short waiting period, full-time employees enjoy a comprehensive benefits package, including:

• Fantastic medical, dental, and vision insurance*

• Twice-annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible

• Employer-paid Basic Life and AD&D

• Employer-paid Short-Term and Long-Term Disability**

• Flexible Spending Accounts*

• 401(k) Retirement Plan with up to a 6% employer match (100% vested after 3 years)

• 10+ paid holidays, generous vacation and sick time

• Annual Volunteer Paid Day

• Annual Tuition Reimbursement

• Annual Health & Wellness Reimbursement

• Fun company events that foster team connection

*60-day waiting period

**90-day waiting period

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Who We are: 

As a trusted third-party administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.

With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs.

To learn more about working at CBG, visit https://www.cobaltbenefitsgroup.com/careers/.