EDI Compliance & Data Specialist

ICW Group; Philadelphia (Philadelphia County); On-site; USD 31,051 - 48,959; Full time

Job summary

ICW Group in Philadelphia is seeking an EDI Compliance Analyst to support the Electronic Data Interchange program across jurisdictions and lines of business. You will help ensure data quality, reporting efficiency, and compliance with Medicare, FROI/SROI, and other regulations.

You will analyze data flows, reconcile daily diaries, assist with audits, and collaborate with Claims, IT, and regulators to resolve issues.

Qualifications

• High school diploma or GED required; some college coursework toward an associate or bachelor’s degree preferred.
• Minimum 2+ years’ claims insurance (or closely related) experience required; good familiarity with EDI is highly desired.

Responsibilities

• Supports Regulatory Reporting, Research, and Compliance Data Management across Medicare, FROI/SROI and IDC reporting.
• Analyzes and validates data at submission time; fixes errors and collaborates with Claims to resolve issues.
• Reconciles daily FROI/SROI diaries to ensure timely transmission of claims data to reporting agencies.
• Monitors EDI queue and assists in clearing backlog diaries, emails, and issues.
• Distributes reports to management per department procedures.
• Participates in internal audits and supports training for Claims Team on regulatory processes.

Skills

Analytical thinking

Problem solving

Attention to detail

Communication skills

Interpersonal skills

Education

High school diploma or GED

Some college coursework toward associate or bachelor’s

Tools

Excel

PowerPoint

Outlook

EDI software

Job description

ICW Group in Philadelphia is seeking an EDI Compliance Analyst to support the Electronic Data Interchange program across jurisdictions and lines of business. You will help ensure data quality, reporting efficiency, and compliance with Medicare, FROI/SROI, and other regulations.

You will analyze data flows, reconcile daily diaries, assist with audits, and collaborate with Claims, IT, and regulators to resolve issues.