Analyst I, Transaction Integrity
Job CodeAITI.224.002
FLSA StatusExempt
Job FamilyTransaction Integrity
Cost Center224
Purpose of Position
Performs transaction verification, payer report analysis, missing remit research, validation testing, edit testing, and X12 specification testing. Analyzes routine issues and supports resolution activities while using approved automation and AI-assisted tools under guidance to improve quality, accuracy, and operational efficiency.
Duties and Responsibilities
Essential Functions
Verifies successful EDI transaction submissions using payer acknowledgement reports.
Researches missing acknowledgements, remittance retrieval issues, balancing discrepancies, and missing remits; documents findings, follow-up activities, and resolution evidence.
Analyzes payer reports and communicates with payer connections and internal teams to support timely issue resolution.
Executes validation, edit, and X12 specification test cases; compares expected and actual results and documents defects, evidence, discrepancies, and issue status.
Collaborates in enhancement planning and continuous improvement initiatives; maintains accurate work-item tracking and documentation and supports timely delivery of transaction integrity, testing, and quality objectives.
Uses approved automation and AI-assisted tools under guidance to support research, testing, analysis, and documentation; validates outputs before use.
Identifies recurring issues and potential automation opportunities, escalates findings to management, and cross-trains across quality assurance, verification, payer analysis, remit research, edit testing, and X12 specification testing.
Acts as a positive role model and observes safety procedures and personnel policies.
Marginal Functions
Other duties as needed.
Skills, Knowledge, and Abilities
Strong proficiency with Microsoft Office applications, combined with the ability to rapidly learn, adapt to, and effectively utilize emerging technologies, automation solutions, AI-assisted tools, and business applications.
Knowledge of healthcare EDI transactions, including 837 transactions, payer acknowledgements, and related transaction workflows.
Ability to analyze transaction outcomes, validation results, operational data, and automated outputs to identify issues, trends, risks, and control gaps.
Ability to apply approved automation and AI-assisted tools to improve research, testing, analysis, documentation, and operational efficiency while maintaining accuracy, security, privacy, traceability, and appropriate human oversight.
Strong organizational, analytical, problem-solving, prioritization, written communication, and verbal communication skills.
Ability to work independently, adapt to changing priorities, and collaborate effectively across functional areas.
Strong proficiency with Microsoft Office applications, combined with the ability to rapidly learn, adapt to, and effectively utilize emerging technologies, automation solutions, AI-assisted tools, and business applications.
Knowledge of healthcare EDI transactions, including 837 transactions, payer acknowledgements, and related transaction workflows.
Must be able to see clearly with or without corrective lenses and hear clearly with or without aids.
Must be able to use hands, fingers and wrists, repetitively, using a computer keyboard and other office equipment, regularly.
Must be able to proficiently speak, read and write in English.
Information Security and Data Protection
The SSI Security-First Mindset
Information security and data protection is a shared responsibility – codified in our commitment to the SSI Security-First Mindset. The SSI Security-First Mindset is comprised of five pillars and universally applicable to all employees, regardless of position description, assigned duties and responsibilities.
The Five Pillars of the SSI Security-First Mindset:
Pillar 1: Governance: Develop, implement, and enforce secure operational processes, procedures, and…