EDI Data Engineer / Claims and X12 / Hybrid

Data Engineer EDI & Claims

Hybrid: 2 days in NYC office, 3 days remote
Salary: Up to $135,000 + generous benefits (including pension plan)
Key Requirement: EDI X12 Experience

About This Role and Why It Matters
Youll be the go-to expert for EDI and claims datahelping ensure compliance, accuracy, and efficiency across health plan operations. Your contributions will shape how we deliver care and meet regulatory standards, making a real difference in peoples lives.

About Us
For over 30 years, weve been a mission-driven healthcare organization dedicated to improving the lives of New Yorkers.

Whats In It For You?

• Make an Impact: Your work will directly improve healthcare for thousands of New Yorkers.
• Flexibility: Enjoy a hybrid schedule that balances collaboration and remote work.
• Growth & Stability: Join a mission-driven organization with over 30 years of success and a strong commitment to employee development.
• Competitive Package: Up to $135,000 salary, comprehensive benefits, and a pension plan.

What Youll Do

• Own and optimize encounter data submissions to state and federal agencies.
• Troubleshoot and resolve EDI mapping issues to keep data flowing smoothly.
• Build and maintain SQL queries, stored procedures, and SSIS jobs for automation.
• Collaborate with internal teams and vendors to solve complex data challenges.
• Support compliance teams with timely, accurate data insights.
• Document workflows and implement data quality checks for continuous improvement.
• Contribute to MMCOR reporting and create KPI dashboards to track performance.

What You Bring

• 5+ years of SQL Server experience (stored procedures, SSIS, SSRS).
• 3+ years working with healthcare data (claims, enrollment, provider).
• Strong knowledge of EDI X12 standards and file mapping.
• Experience with BI tools (Tableau, Power BI, BusinessObjects).
• Bonus: Familiarity with Visual Studio, .NET, XML, BizTalk.
• Bachelors degree in Information Systems, Computer Science, or related field.
• Must be legally authorized to work in the U.S. (no sponsorship available).

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