Enrollment Data Analyst (Healthtech)

TL;DR

Enrollment Data Analyst (Healthtech): Managing the end-to-end lifecycle of member enrollment data with an accent on EDI 834 file processing, data validation, and system integrity. Focus on resolving complex data discrepancies, executing SQL-based audits, and ensuring compliance with CMS and ACA guidelines within a high-volume health plan environment.

Location: Must be based in the United States within the Central (CST) or Eastern (EST) time zone.

Company

hirify.global is a high-technology health plan division of Globe Life, dedicated to increasing transparency and access to healthcare through a personalized, human-centric approach.

What you will do

• Configure and troubleshoot inbound/outbound HIPAA 834 transaction files with trading partners.
• Perform systematic validation of member records against eligibility rules and source documents.
• Execute SQL queries to identify, extract, and correct data anomalies and legacy migration issues.
• Process member adds, terminations, and changes in compliance with CMS and ACA guidelines.
• Collaborate with engineering and claims teams to resolve data issues affecting downstream adjudication.
• Maintain accurate documentation for all manual data changes to meet audit and compliance standards.

Requirements

• 2+ years of experience in health plan enrollment operations, managed care, or EDI data processing.
• Hands-on experience with HIPAA 834 transaction processing and X12 EDI standards.
• Proficiency in SQL for querying, validating, and correcting data in relational databases.
• Experience working within claims administration systems (e.g., QNXT, TriZetto, HealthEdge).
• Must reside in the US within the Central (CST) or Eastern (EST) time zone.
• Must maintain a dedicated, private workspace for handling confidential information.

Nice to have

• Experience with web-based enrollment portals or member engagement UIs.
• Exposure to EDI mapping tools like Edifects or Claritev.
• Familiarity with population health platforms or care management systems.
• Experience supporting IRS Form 1095 or CMS risk adjustment submissions.

Culture & Benefits

• Fully remote work environment.
• Standard business hours (9:00 AM – 5:00 PM CST) with occasional flexibility.
• Opportunity to work at the intersection of healthcare operations and data engineering.
• Focus on data integrity and mission-critical health plan administration.