Workers Compensation Claims EDI Analyst

Responsibilities

• Pairs between IT and business units to monitor, support, and maintain EDI workflow.
• Serves as a conduit between business units, IT, and Regulatory Reporting departments.
• Supports, monitors, troubleshoots, and maintains EDI transactions for Workers’ Compensation First Report of Injury (FROI), Workers’ Compensation Subsequent Report of Injury (SROI), Medicare and ISO.
• Maintains data dictionaries and maps on inbound and outbound transactions.
• Identifies and implements process improvements.
• Develops and maintains EDI documentation.
• Analyzes and identifies data issues requiring overrides in core systems or assistance with data mapping between systems.
• Prepares written business requirements representing the business need and ensuring grammatical correctness.
• Communicates effectively with internal teams and external vendors to deliver functional requirements like user screens and interface designs.
• Performs other duties as assigned.

Qualifications

• Bachelor’s degree or equivalent work experience.
• Minimum of 7 years of related IT experience.
• Experience working with EDI Release 3.0 and 3.1 for all states is a must.
• Experience working with a commercial insurance carrier with exposure to auto, liability, and workers’ compensation lines of business.
• Strong knowledge of various technical designs and specifications.
• Partner closely with business user community to ensure cross-functional alignment to meet goals with an excellent sense of customer service.
• Excellent communication and analytical skills.
• Strong problem-solving, conflict resolution, and negotiating skills.
• Excellent organizational skills while managing multiple project initiatives, schedules, and meeting deadlines.
• Superior logical, analytical, and reasoning abilities with close attention to detail.
• Willingness to travel up to 15%.

Benefits

• Base Salary Range: $90,000-$115,000.
• Eligible to participate in annual discretionary bonus.
• Benefits: Health, Dental, Vision, Life, Disability, Wellness, Paid Time Off, 401(k) and Profit-Sharing plans.