EDI Analyst I

Western National Group & Umialik Insurance•Edina, MN

55m•Hybrid

About The Position

Western National is seeking an EDI Analyst – Medicare to join our team! The individual in this role will have the opportunity to coordinate accurate and complete electronic transmission of Medicare forms and data, ensuring compliance with regulatory requirements while supporting data integrity, error resolution, and continuous process improvement.

Requirements

Demonstrated experience with data integrity, validation, and issue resolution.
Working knowledge of personal and commercial claims processes.
Strong analytical and problem-solving skills.
High attention to detail and accuracy.
Ability to follow established processes and meet deadlines consistently.
Strong communication skills with the ability to engage both technical and nontechnical audiences.
Proven collaboration and teamwork skills.
Customer service mindset with a focus on responsiveness and ownership.

Nice To Haves

Bachelor’s degree or equivalent experience.
Experience working with multiple systems and platforms, including Verisk.
Knowledge of IAIABC, NCCI, and Section 111 reporting standards.
Insurance industry certifications or additional Medicare experience.
Experience supporting or delivering training related to systems or compliance.

Responsibilities

Coordinates the accurate and timely electronic transmission of Medicare forms and data in compliance with regulatory requirements.
Provides subject matter expertise on Medicare reporting processes and supports the development of documentation and training materials.
Communicates updates and changes in Medicare requirements and processes to internal stakeholders.
Troubleshoots reporting errors and data issues, collaborating with internal and external partners to resolve discrepancies.
Analyzes and interprets Medicare requirements to ensure alignment with policy, form, and regulatory updates.
Identifies reporting issues and recommends solutions to improve accuracy, efficiency, and compliance.
Maintains accurate records and updates data fields within systems and reporting platforms.
Assists in training internal stakeholders to reduce errors and increase understanding of Medicare compliance requirements.
Collaborates with the claims, compliance, and IT teams to ensure proper system configuration and functionality.
Identifies the potential impacts of new requirements, including needed updates to policy and form language.
Participates in team-based problem solving and escalates complex or nonroutine issues as appropriate.