Electronic Data Interchange (EDI) Technical Specialist

The EDI Quality Assurance (EDI QA) team helps ensure the accuracy and integrity of workers’ compensation claims data reported to the Virginia Workers’ Compensation Commission. We work closely with employers, insurance carriers, claim administrators, and other stakeholders to support EDI reporting, resolve data issues, maintain compliance standards, and improve data quality across Virginia’s workers’ compensation system.

As an EDI Technical Specialist, you’ll help investigate reporting issues, resolve transaction errors, support customers, and ensure critical claims information is processed accurately.

What You’ll Do

As an EDI Technical Specialist, you’ll combine customer service, problem-solving, data analysis, and technical support to help keep Virginia’s workers’ compensation reporting system running smoothly.

Key responsibilities include:

• Responding to customer inquiries related to EDI filings, corrections, consolidations, and compliance requirements
• Researching and resolving rejected, flagged, or failed EDI transactions
• Analyzing claims data and electronic submissions to identify reporting issues
• Reviewing and processing claim consolidation requests and related documentation
• Interpreting and applying EDI reporting requirements, procedures, and regulations
• Collaborating with internal teams, insurance carriers, employers, and third-party administrators
• Maintaining accurate documentation and ensuring high standards of data quality
• Supporting process improvement and quality assurance initiatives

Do you have experience in Research?, If you’re detail-oriented, naturally curious, and enjoy investigating issues until you find the solution, this may be the perfect opportunity to grow your career while making a meaningful impact in public service., * Enjoy analytical and investigative work

• Have strong attention to detail and data accuracy
• Thrive in environments where priorities and issues change throughout the day
• Are comfortable researching regulations, procedures, and technical requirements
• Can communicate complex information clearly and professionally
• Enjoy solving problems and identifying root causes
• Balance independent work with collaboration across teams

• Take ownership of customer issues and follow through to resolution Have a strong commitment to quality, accuracy, and customer service *, * Experience providing customer service in a professional office environment

• Experience with data entry, claims processing, records management, or administrative support functions
• Strong attention to detail and ability to maintain accuracy when processing large volumes of information
• Strong written and verbal communication skills
• Experience working with databases, business systems, or electronic records
• Ability to research information, interpret procedures, and solve problems independently Proficiency with Microsoft Office applications, including Outlook, Word, and Excel *

Additional Considerations

• Experience working with workers’ compensation programs, procedures and practices with emphasis on EDI compliance.
• Experience with workers’ compensation EDI programs, data reporting, claims processes and/or insurance processes.
• Knowledge of Virginia Workers’ Compensation rules, regulations, or business processes Experience using PowerBi or other data query tools