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(Remote) EDI Support Specialist - Casualty
PRIMARY PURPOSE : To identify, research, resolve, and respond to complex technical EDI issues or questions received from internal and external customers; escalates issues to the appropriate parties; provides status and follow up information to internal or external customers; and assists real-time in the resolution of support issues to decrease penalty exposure.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Advises and supports EDI Support Associates and EDI Support Representatives on a variety of complex issues including expert review of International Association of Industrial Accident Boards and Commissions (IAIABC) standards, individual state EDI event tables, and element requirement tables. Edits matrix tables and change logs and applies them to the technical EDI mapping in JURIS identifying system defects and managing escalation and resolution with the EDI IT team.
Responds to telephone calls, emails, and technical support requests; assists internal customers by troubleshooting error events to resolve EDI related issues ensuring timely and accurate adherence to state regulator expectations; and documents, tracks, and monitors issues ensuring a timely resolution.
Assists in roll-out of state EDI implementations, new client implementations, and client program changes that impact EDI.
Oversees complex EDI troubleshooting; notifies operations and external customers of state acknowledgement delays, error issues, JURIS technical issues, jurisdiction and vendor issues/delays, etc.
Trains internal colleagues, clients, state representatives and EDI vendors as required on EDI processes, technical programming, utilization of the EDI vendor system, state and client implementations, parameter set up, data mapping and the IAIABC EDI Standard. Creates EDI job aids and training materials.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
High school diploma or GED required. Associate degree in a computer technology field preferred.
Experience
Five (5) years of related experience to include two (2) years of workers' compensation or claims related experience and three (3) years of EDI technical experience including interpretation of IAIABC implementation tables or equivalent combination of education and experience required. JURIS or claims management application experience preferred.
Skills & Knowledge
Demonstrates extensive knowledge of IAIABC Standards, individual state EDI event tables, element requirement tables, edit matrix tables and change logs and JURIS EDI technical mapping; existing workers' compensation claim systems, workers compensation adjuster job functions, client parameter structures, assigned state EDI paperwork requirements, implementations and conversions processes, pay code use, and company workflow and processes to the degree needed to solve support related issues.
Excellent oral and written communication skills, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to create and complete comprehensive, accurate and constructive written reports
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (42,310.00 - 55,000.00). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #remote
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com
