Electronic Data Interchange Analyst

Lead EDI Specialist / HIPAA X12 Consultant

Raleigh, North Carolina (Onsite Only)

accel bi corporation

Full-Time W2 Employment

Salary: $55,000 – $60,000 per year

LOCAL candidates only

Join a Mission-Critical Healthcare Transformation Initiative

accel bi corporation is seeking an experienced and highly skilled Lead EDI Specialist / HIPAA X12 Consultant to support a prestigious healthcare modernization initiative with the North Carolina Department of Health and Human Services (NC DHHS). This is a high-visibility role supporting enterprise Medicaid and Managed Care transformation programs that directly impact statewide healthcare systems and citizens.

We are looking for a seasoned EDI professional with deep expertise in HIPAA X12 transactions, healthcare claims processing, trading partner management, QA/testing, and Medicaid/MMIS environments.

This is an excellent opportunity to work on a large-scale government healthcare initiative with significant long-term impact.

Key Responsibilities

• Lead EDI testing and validation activities for HIPAA X12 transactions
• Develop and execute comprehensive test scripts for X12 transmission processes
• Perform QA testing and troubleshooting for EDI applications and integrations
• Manage and support EDI transaction sets including:
• 837
• 277CA
• 834
• 835
• TA1
• 999
• 820
• NCPDP D.0
• Configure and maintain Trading Partner relationships, standards, envelopes, and end-to-end testing
• Monitor inbound and outbound EDI transactions and resolve transmission issues
• Collaborate with healthcare providers, vendors, and trading partners to resolve EDI-related challenges
• Maintain EDI documentation, workflows, validation rules, and process standards
• Support customer service and internal business teams on EDI issues
• Analyze EDI transactions and generate operational reports and metrics
• Identify and implement process improvements for EDI systems and operations
• Participate in Agile project delivery and user acceptance testing (UAT)

Required Qualifications

Mandatory Skills & Experience

• 7 years of experience developing and executing test scripts related to HIPAA X12 EDI transmissions
• Strong expertise in:
• HIPAA X12 EDI Transactions
• EDI mapping
• Healthcare claims processing
• Hands-on experience with:
• 837
• 277CA
• 834
• 835
• TA1
• 999
• 820
• NCPDP D.0
• Proven experience conducting QA and testing on EDI applications
• Experience setting up Trading Partner relationships, standards, envelopes, and full-cycle testing
• Strong experience processing and monitoring inbound/outbound X12 transactions
• Experience troubleshooting EDI processing errors and collaborating with partners to resolve issues
• Knowledge of Agile methodology
• Excellent communication and stakeholder collaboration skills

Highly Preferred

• Medicaid and/or MMIS experience
• Healthcare provider and claims processing domain knowledge
• Experience working in government healthcare environments

Location Requirement

LOCAL NORTH CAROLINA CANDIDATES ONLY

Candidates must currently reside in North Carolina and be available to work onsite in Raleigh, NC.

Important Employment Requirements (Please Read Carefully)

• accel bi corporation does NOT sponsor H1B visas or any employment visas for this position.
• Candidates must have valid U.S. work authorization.
• GC or USC candidates only (No OPT or H1B candidates for this role).
• Proof of work authorization is required.
• Candidates must have relevant work experience within the United States.
• This is an onsite-only position (No remote or hybrid work).
• This is a full-time direct employment opportunity with accel bi corporation.

Required Submission Documents

Candidates must submit:

• Updated resume in Word format
• Three professional references including:
• Name
• Title
• Company
• Contact Information

Only candidates meeting all above requirements will be considered.

Why Join accel bi corporation?

At accel bi corporation, you’ll work alongside top professionals on transformative public-sector healthcare programs that drive meaningful impact. We value innovation, accountability, collaboration, and technical excellence.

If you are passionate about healthcare EDI systems and want to contribute to a mission-critical Medicaid modernization initiative, we encourage you to apply today.