EDI Operations Manager - Benefits Administration

Job Type Full-time Description

    

We are seeking an experienced and strategic EDI Operations Manager to lead the implementation, oversight, and continuous improvement of our electronic data interchange (EDI) processes within the benefits administration space. This role is pivotal in managing a team of EDI Analysts and ensuring high-quality, accurate, and timely data exchanges between our internal systems, external carriers, and broker partners using Selerix BenSelect.

As a leader in the Benefits Technology department, you will work closely with internal departments, external brokers, and benefits carriers to manage file feeds, troubleshoot complex issues, and guide the team through key milestones including open enrollment, onboarding, and system upgrades.

This role is critical to ensure ongoing scalability, quality, and compliance in our benefits data exchange processes. With growing client demand and increasing carrier file complexity, a dedicated manager is needed to lead the team, optimize file operations, and serve as the key point of accountability for internal and external stakeholders.

  

Essential Duties and Responsibilities:

· Lead, mentor, and develop a team of EDI Analysts responsible for day-to-day operations of benefits data exchanges.

· Oversee all aspects of EDI file implementation, testing, maintenance, and monitoring using Selerix.

· Serve as the escalation point for complex EDI mapping and transmission issues across group health, dental, vision, and ancillary products.

· Develop and maintain SOPs, file specifications, carrier requirements, and internal documentation.

· Partner with internal teams (Client Services, Account Management, Sales, and IT) and external stakeholders (brokers and carriers) to support data exchange needs, troubleshoot issues, and ensure alignment.

· Establish performance metrics, quality assurance protocols, and audit controls to ensure timely and accurate file processing.

· Support regulatory compliance activities related to HIPAA through accurate data management and secure transmission practices.

· Lead project initiatives for onboarding new clients or carriers, open enrollment file readiness, and platform enhancements.

· Provide regular reporting on department metrics, operational risks, and opportunities for process improvement.

· Conduct regular team meetings, performance reviews, and training sessions to ensure continuous growth and consistency.

· Oversee the configuration, maintenance, and optimization of EDI file feeds within Selerix BenSelect.

· Participate in planning and execution of new client implementations, open enrollment initiatives, and system integrations.

· Serve as the escalation point for complex data mapping, transmission failures, and exception handling.

· Implement quality control practices to minimize data discrepancies and transmission errors.

· Monitor and report on transmission logs, audit files, and reconciliation reports.

· Provide leadership with regular updates on performance metrics, compliance status, and system efficiency.

Requirements

  

Qualifications

Required

• 7+ years of experience in EDI analysis/administration in the insurance or employee benefits sector.
• 4+ years of management or team lead experience, preferably in a technology or      operations function.
• Deep knowledge of Selerix BenSelect, ANSI 834 files, and      benefits-related EDI standards.
• Strong leadership, communication, and problem-solving skills.
• Proven ability to collaborate cross-functionally with both technical and non-technical stakeholders.
• Advanced Excel proficiency: ability to audit and reconcile data quickly and accurately.

Preferred Prior experience working directly with insurance brokers and carrier partners.

• Familiarity with ACA reporting, COBRA processes, and enrollment lifecycle management.
• Project management or systems implementation experience is a plus.

 
Education: 

• Bachelors Degree preferred but not required

  

Attendance Requirements:

· Remote role 

· Daily attendance is required during normal business working hours

· In-person attendance is occasionally required for company, client and/or team meetings outside of the normal schedule.

· The Company reserves the right to request in-person attendance at the Company’s worksite at any time. The Company also reserves the right to make full-time attendance at the Company’s worksite an essential job function for this