Position OverviewEvryHealth is seeking a detail-oriented Enrollment Data Analyst to support the accuracy, integrity, and operational reliability of member enrollment data across our health plan systems. This role sits at the intersection of EDI operations, data quality, and health plan administration — owning the end-to-end lifecycle of enrollment data from inbound 834 file processing through system validation, data entry, and ongoing maintenance.About Evry Health and Globe LifeWe are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives.Evry Health is the major medical division of Globe Life (NYSE: GL). Globe Life has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.Key Responsibilities 834 EDI Exchange & Enrollment Processing Configure, monitor, and troubleshoot inbound and outbound HIPAA 834 (Benefit Enrollment and Maintenance) transaction files with trading partners, employers, and TPAsValidate 834 file structures for compliance with X12 5010 standards, identifying and resolving segment errors, loop discrepancies, and rejected transactionsCoordinate with trading partners to resolve enrollment exchange issues and ensure timely, accurate file transmissionData Validation & Quality AssurancePerform systematic validation of member enrollment records against source documents, 834 transactions, and plan eligibility rulesIdentify data anomalies, duplicate records, coverage gaps, and demographic inconsistenciesExecute data quality audits on a scheduled and ad-hoc basis, documenting findings and remediation stepsEnsure enrollment data aligns with plan effective dates, benefit periods, and group contract termsData Entry & MaintenanceAccurately enter and update member demographic, eligibility, and coverage data across the web UI enrollment portal and the claims processing systemProcess member adds, terminations, changes, and reinstatements in a timely manner in compliance with CMS and ACA guidelinesMaintain supporting documentation for all manual data changes per audit and compliance standardsData Cleanup & Remediation Lead targeted data cleanup projects to address backlogs, legacy migration issues, and discrepancies identified through audits or operational escalationsWrite and execute SQL queries against enrollment and member databases to identify, extract, and correct data issuesCollaborate with the engineering team on bulk update scripts and data remediation workflows Cross-Functional Collaboration Partner with engineering, claims, and population health teams to surface enrollment data issues affecting downstream claim adjudication, reporting, and care management workflowsSupport compliance and reporting requirements including ACA 1095-B and CMS enrollment submissionsCommunicate enrollment discrepancies and resolution status to internal stakeholders and external partners Required Qualifications2+ years of experience in health plan enrollment operations, managed care, or EDI data processingHands-on experience with HIPAA 834 transaction processing and X12 EDI standardsProficiency with SQL-- able to write queries to retrieve, validate, and correct enrollment data directly against relational databasesExperience working within claims administration systems (e.g., Plexis QC, QNXT, TriZetto, HealthEdge, or similar). Strong attention to detail with a proven ability to manage high volumes of data accurately Familiarity with ACA eligibility and enrollment rules, CMS guidelines, and HIPAA data privacy Preferred Qualifications Experience with web-based enrollment portals or member engagement UIsUnderstanding of downstream impacts of enrollment data on claims adjudication and provider rostersExposure to EDI mapping tools or translation software (e.g., Edifects, BizTalk, or Claritev). Familiarity with population health platforms or care management systemsExperience supporting IRS Form 1095 or CMS risk adjustment data submissions Tools & Systems EDI / Enrollment Exchange: 834 X12 5010, trading partner portals, ClaritevEnrollment Web UI: Internal member management portalClaims System: Health plan claims adjudication platformDatabase: SQL Server (direct query access)Office Productivity: Excel, SharePoint, ticketing systemsCompetencies Data Accuracy— Treats data integrity as mission critical; catches errors before they propagateProblem Solving— Traces enrollment issues to root cause across EDI, UI, and database layersCommunication— Translates technical data issues into clear, actionable summaries for non-technical stakeholdersUrgency & Organization— Manages competing priorities, meets SLAs for enrollment processing windowsCollaboration— Works fluidly across operations, engineering, and compliance teams Work EnvironmentThis is a fully remote position. Candidates must reside in the United States within the Central (CST) or Eastern (EST) time zone.Standard business hours are Monday through Friday, 9:00 AM – 5:00 PM CST, with occasional flexibility required to meet regulatory response deadlines.Must maintain a dedicated, private workspace that is separate from other living areas and supports the secure handling of confidential information.Must have a reliable high-speed internet connection.All company-sensitive documents must be kept secure and handled in accordance with Evry Health data privacy and security policies.
