Medicare EDI Compliance Specialist

Job Summary

A company is looking for a Medicare and EDI Senior Specialist.

Key Responsibilities

• Ensure compliance with Medicare Secondary Payer (MSP) regulations and manage reporting requirements
• Resolve EDI errors and collaborate with internal teams for process improvement
• Conduct training sessions and assist in quality assurance and auditing processes

Required Qualifications

• 8-12 years of experience in workers' compensation compliance, Medicare reporting, or EDI processes
• Deep expertise in Medicare Secondary Payer (MSP) regulations and MMSEA Section 111 requirements
• Advanced knowledge of EDI standards and state-specific reporting requirements
• Experience with CMS systems and data analysis processes
• Strong understanding of workers' compensation regulations across multiple jurisdictions