• Maintains high data quality standards across all projects and initiatives as related to EDI • Leads the process of ensuring all state specific requirements are appropriately tracked and implemented with vendor partner and within claims platform • Performs thorough verification and validation of data entries to ensure accuracy and completeness • Identifies, tracks, and rectifies discrepancies, inconsistencies, and errors in datasets through careful analysis and investigation • Utilizes data management tools to conduct data verification processes efficiently • Documents and reports findings, issues, and resolutions • Maintains daily rejection and error reports to stay informed on the efficiency, timeliness, and accuracy of the claims EDI program • Solves reporting errors or state criticisms and respond to inquiries regarding reporting matters • Stays updated on industry trends, emerging technologies, and best practices related to data verification and quality assurance • Proactively monitors proposed changes from states to their EDI process or order of items to be submitted. Ensures implementation of necessary updates for EMC to remain in compliance • Collaborates with internal leadership and IT to monitor timely implementation of required system changes/upgrades, and vendor partners to facilitate data collection, resolve data-related queries and ensure effective use of vendors, communicating updates throughout the process • Monitors reporting activity and assists in ensuring the timely completion of action items • Monitors states where vendor support is not possible based on state requirements • Serves as the primary contact between EMC and vendor as audits occur. Recommends best practices to ensure alignment with state requirements as identified • Researches and tracks untimely filings resulting in penalties in multiple jurisdictions • Identifies opportunities for process improvement to enhance the efficiency and effectiveness of the EDI workflow • Ensures compliance with data reporting requirements set by regulatory agencies, ensures adherence to specific data instructions and standards, and timely submissions • Collects, organizes, and analyzes data to report to claims team leadership • Researches EDI compliance standards and maintains compliance workflows for all jurisdictions, where applicable • Provides training and support to internal users on processes, protocols, proper utilization/efficiency implementation, and systems • Participates in continuous improvement and efficiency initiatives aimed at optimizing data verification processes and workflows • Maintains relationships with the claims team members and jurisdictional parties to ensure compliance and prompt responses to penalties imposed, where applicable • Partners with Quality Assurance and WC Claims leadership to determine if issues persist and if targeted or large scale training is appropriate • Supports claim goals by leading, assisting and/or owning a process, special projects and assignments as directed by Claims Leadership