Business Analyst – Eligibility; EDI

Job Title: Business Analyst
- Eligibility (EDI)

Location: Remote (Boston, MA base; Washington, DC on-site if required)

Employment Type: Contract (W2 through Zip Staff
- No C2C or 1099)

Zip Staff is seeking an experienced Business Analyst specializing in Electronic Data Interchange (EDI) to drive key project deliverables for a leading healthcare organization.

This role focuses on implementing 834 and proprietary eligibility, COB, and group files for various health plans. The analyst will independently lead the design and implementation of end-to-end frameworks for processing eligibility exchanges, facilitate stakeholder discussions, create comprehensive documentation, and conduct rigorous end-to-end testing. This is a short-term contract assignment (through 12/31/2026) supporting a pre-identified vendor-to-W2 conversion opportunity. Work mode is primarily remote with a Boston, MA base worksite.

• Be a self-starter with the ability to work independently and with minimal oversight.
• Quickly develop a comprehensive understanding of the business rules, core platforms, and applications for the data used in EDI exchanges.
• Lead the design and implementation of innovative end-to-end frameworks for processing eligibility exchanges, ensuring they meet both business needs and industry standards.
• Facilitate and lead discussions with plans and other stakeholders to identify and clarify requirements, review UAT test cases, and ensure alignment on project objectives and deliverables.
• Develop comprehensive documentation outlining business rules, process flows, and technical specifications.
• Conduct multiple rounds of end-to-end testing with strong prior experience in developing and performing test scenarios.

• Bachelor's Degree required.
• Expertise in Electronic Data Interchange (EDI).
• Experience implementing 834 and proprietary eligibility, COB, and group files for health plans.
• Strong prior experience in developing and performing test scenarios for end-to-end testing.
• Ability to work independently, facilitate stakeholder discussions, and produce clear documentation.
• Ability to work primarily remote (Boston, MA base worksite).

• Prior experience supporting eligibility exchanges or related EDI processes in a healthcare payer environment.
• Hands-on experience with health plan eligibility, COB, and group file implementations.
• Track record of leading requirements discussions and UAT reviews with health plan stakeholders.
• Experience producing process flows, business rules documentation, and technical specifications for EDI frameworks.

• Health Insurance.
• Dental Insurance.
• Vision Insurance.
• 401(k) + 401(k) matching.
• Paid time off.
• Referral Program.