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EDI Business Analyst

Product Management · Mountain View, California
Department Product Management
Employment Type Full-time
Minimum Experience Experienced

GetInsured is a cloud-based Healthcare Exchange Platform used by nearly 1 in 5 Americans who enrolled in coverage from 2014 to 2017. We build tools and services that enable consumers to have greater control over their healthcare choices. Our customers are consumers, employers, Healthcare marketplaces, benefits consultants and health insurers. One of our most significant challenges lies in transforming complex industry processes to delightful and satisfying user experiences for healthcare shoppers online, while at the same time keeping our technology platform scalable and flexible enough to adapt to the changing insurance landscape.

Who You’ll Be Working With:

We are looking for a bright and energetic individual to join our carrier / enrollment support team interfacing with both State exchanges and carriers to address questions, intake requests, and be the initial primary contact for both parties. This person will also work with internal product management, development and QA teams to convey the customer’s needs and help define new requirements to further develop the product.  Foremost in mind for this person should be a drive to provide the best end to end experience between the State exchange and carriers.

What You’ll Be Doing:

  • Interact with new and current assigned clients and trading partners to capture and analyze requirements, mapping specifications and project objectives.
  • As new clients are onboarded, manage the carrier testing process.
  • Monitor ongoing EDI exchanges and proactively identify and address issues.
  • Assist in defining business requirements and acceptance criteria/test cases that support EDI Interfaces related to healthcare business platform including but not limited to the 834 and 820 EDI transactions.
  • Assist in defining business requirements and acceptance criteria/test cases that support health insurance exchange standards related to healthcare business platform.
  • Utilize a variety of software and platforms for statistical analysis and research concerning data
  • Assist in creating and standardizing solutions and workflows.
  • Perform business analysis of identified process and software gaps or inefficiencies and develop plans to fill those gaps for internal business processes and for external clients.
  • Perform requirements review with external and internal stakeholders and obtain sign off from all required individuals.
  • Provide training to staff and clients and trading partners on new enhancements.
  • Identifies and documents system deficiencies and recommends solutions.
  • Ensures continuing operational quality by documenting fixes and enhancements.

 The Experience You’ll Need (Required):

  • Extensive knowledge in health insurance concepts to specifically support EDI Interfaces.
  • Working knowledge of communications for EDI transmissions using FTP, SFTP and real time API setups; or ability to learn
  • Strong communication skills with working session facilitation.
  • Strong time management and organizational skills.
  • Excellent interpersonal, oral and written communication skills.
  • SQL experience. Understanding of relational DB schemas.
  • Strong attention to detail and organization.
  • Able to work independently and within a collaborative team environment with little guidance/supervision.
  • 5+ years of computer skills, especially: Word, Excel, Power Point, ticketing systems
  • 5+ years of experience leading projects and cross functional teams in an automated production environment.
  • Ability to successfully balance deadlines, projects, and day to day responsibilities.

Finishing Touches (Preferred):

  • Associate or Bachelor’s degree preferred.
  • Extensive experience in health insurance ANSI ‘X12 transaction sets (i.e. 834, XML and flat files) and HIPAA standards
  • Certified Business Analyst is strongly preferred; equivalent demonstrated business analysis experience.
  • Extensive experience with the System Design Life Cycle (SDLC).
  • Superior root cause analysis skills, including corrective action planning and ability to provide documentation to support analysis.

This position is located in Mountain View, CA. The selected candidate must be open to moving to the San Francisco Bay Area.

What we offer:

A challenging, consumer-facing problem space, where you can make an immediate impact. You’ll be wearing multiple hats and working on various projects and teams. You will get your hands dirty with the latest technologies, learn to use new tools and get the opportunity have your say in the final product. You’ll work alongside a great team that assumes the best intentions, and makes every effort to show empathy and care in all interactions. We’re a well-funded, stable startup with excellent salaries, medical/dental/vision coverage, and perks. GetInsured is an Equal Opportunity Employer.


  • Health, Dental, Vision, Life, Disability
  • 401k match
  • Stock options
  • Catered lunch twice a week. Kitchen stocked with snacks, fruits, drinks.
  • Onsite Yoga
  • Yearly Education allowance

Thank You

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  • Location
    Mountain View, California
  • Department
    Product Management
  • Employment Type
  • Minimum Experience