The Role:
- EDI is the invisible infrastructure of healthcare billing. As The Architect, you will manage trading partner onboarding, data mapping, HIPAA/ANSI X12 compliance, real-time transmission monitoring, error resolution, integrations, and automation improvements.
- You identify silent failures before they impact operations and ensure claims, eligibility checks, and remittance transactions move accurately and seamlessly across every payer connection.
What You Will Own – Your Responsibilities :
- Trading Partner Onboarding — Configure mappings, validate formats, and ensure HIPAA/ANSI X12 compliance
- EDI Error Handling — Monitor real-time transmissions, identify root causes, and document resolutions
- Data Mapping & Integration — Maintain accurate system and payer data mappings
- Performance Monitoring — Track transaction success rates, error trends, and transmission health
- Regulatory Compliance — Ensure adherence to HIPAA/ANSI X12 and payer standards
- Automation Improvement — Reduce manual EDI tasks through workflow automation
Non-Negotiable Metric :
- EDI TRANSACTION ACCURACY RATE · TARGET: ≥ 99%
- Percentage of EDI transactions processed successfully without transmission or mapping errors across all trading partners monthly.
The Fight: What You will Fight:
- The unmapped field
- The broken payer configuration
- The failed transmission hidden inside thousands of successful ones
- The unnoticed rejection that delays revenue downstream
No one sees the failure until claims stop moving – Your responsibility is to see it first.
WHO THRIVES HERE : Three Traits We Cannot Teach
- System Thinking — Identify root configuration issues and prevent recurring failures
- Precision in Format — Ensure accurate EDI mappings and error-free transmissions
- Calm Under Pressure — Resolve EDI failures with structured troubleshooting and clear root-cause analysis
THE WWS PERKS :
- Full training in EDI systems and HIPAA/ANSI X12 standards
- Exposure to payer integrations and healthcare transaction workflows
- Clear ownership and performance-driven operations
- Hands-on experience in EDI systems and automation
- Career growth opportunities in healthcare operations
- Culture focused on reliability, accountability, and system performance
Qualifications:
- Experience: 3+ years of experience in healthcare transactions, data mapping or documentation work with team leadership.
- Education: Bachelor’s degree in any discipline.
- Technical Understanding: Strong understanding of EDI workflows, HIPAA/ANSI X12 standards, and healthcare transaction systems.
- Leadership Skills: Experience in handling teams, driving operational performance, and managing issue escalations.
- Analytical Skills: Strong troubleshooting and root-cause analysis abilities.
- Communication: Effective coordination with internal teams, payers, clients, and stakeholders.
- Documentation: Proficient in maintaining clear, structured, and audit-ready documentation.
Contact us on jobs@wonderws.co / 9047477375
To Apply: https://careers.wonderws.com
