Senior (EDI) Electronic Data Interchange Coordinator

Summary Statement

Independently monitors and updates internal claims data to ensure timeliness and quality of data for transmission. Analyzes data quality and timeliness issues and communicates findings to adjusting staff and leadership. Manages claims vendor database to ensure data entered is accurate.

Essential Tasks / Major Duties

• Monitor existing worker's compensation EDI transactions and work with internal departments and vendors to correct errors and resubmission ensuring data is accepted by insurance regulators.
• Investigate errors to determine root cause and resolution and communicate lessons learned to claims staff, information technology and/or vendor partners.
• Analyze periodic worker's compensation EDI data evaluation reports to promote data quality.
• Manage and resolve claim system inquiries and/or transfer to appropriate staff.
• Monitor Claim Administration email inbox and respond or escalate as appropriate.
• Monitor, reconcile and maintain vendor information in database and assist tax department with filings.
• Review, approve or reject additions or changes of vendor data ensuring accuracy of the database.
• Develop requirements for claims system changes and enhancements.
• Perform user acceptance testing for system updates related to EDI.
• Provide training to claims staff on workers' compensation EDI transactions and business processes.
• Responsible for claim transfer process.
• Serve as subject matter expert providing information to support audit and state regulatory inquiries.
• Participate in claims department projects as assigned.

Knowledge, Skills & Abilities

• High school diploma or GED.
• 2 years worker's compensation EDI or worker's compensation claims adjuster experience.
• Proficient computer skills required, including Microsoft Office Suite.
• Ability to work effectively with minimal supervision.
• Demonstrated successful ability to build positive relationships and partnerships within department, across the organization and with external customers.
• Excellent problem solving, critical thinking and decision-making skills.
• Strong analytical skills and attention to detail.
• Excellent verbal and written communication skills with the ability to interact with internal and external customers.
• Excellent organizational skills, including ability to multi-task and prioritize workload.