Lead EDI Specialist (Philadelphia)

Position Title : Lead EDI Specialist

Location : Philadelphia, PA (3 days / week onsite)

Work Type : Contract to hire

Overview :

We are seeking a highly analytical and solutions-driven Lead EDI Specialist to oversee and support EDI enrollment operations for our Core Enrollment team. This role serves as both a technical subject matter expert and a team lead, ensuring that all EDI enrollment files (including 834 and alt 834 transactions) are processed accurately, reconciled efficiently, and delivered with exceptional quality.

Key Responsibilities :

• Lead reconciliation efforts for Core Enrollment Operations, ensuring all systems are accurately updated.
• Review complex inbound 834 and alt 834 file issues in both pre-edit and post-release environments, developing best practices for analysis, reconciliation, and resolution.
• Oversee production files for clients, ensuring successful transmission, validation, and follow-up on any discrepancies.
• Manage the flow of inbound EDI files for client business, ensuring timelines and quality standards are met.
• Act as a liaison between Core Enrollment Operations and other key groups (Vendors, UST, SDS, BTS, Compliance, Marketing, Client Implementation) on enrollment-related initiatives.
• Serve as the subject matter expert (SME) for group requests and coordinate technical and process changes.
• Document and prioritize system limitations; collaborate with BTS to identify and implement technical solutions or automation opportunities.
• Lead resolution efforts for enrollment-related issues in the Enrollment Resolver Group.
• Organize and distribute project and operational work among a team of 16, providing guidance, feedback, and support.
• Develop and maintain procedures, job aides, DLPs, service alerts, and policies for enrollment processes.
• Manage initial enrollment file loads for new client installations.
• Provide coaching, training, and technical assistance to team members; serve as a resource for less experienced colleagues.
• Conduct data analysis and maintain accuracy of internal trackers to monitor productivity and timeliness.
• Lead or contribute to special projects and automation initiatives, including managing Robotic Process Automation (RPA) activities for the business area.
• Prepare and deliver executive-level communications and facilitate meetings with internal and external stakeholders.

Knowledge, Skills & Abilities :

Education & Experience :