Medicare and EDI Senior Specialist - Remote

Overview

The Medicare and EDI Senior Specialist will serve as Pie's internal subject matter expert for both Medicare Secondary Payer (MSP) compliance and assist the Senior EDI Specialist with Electronic Data Interchange (EDI) reporting requirements. This role is critical to ensure compliance with federal Section 111 Medicare, Medicaid, and SCHIP Extension Act (MMSEA) reporting mandates and state-specific EDI requirements across all jurisdictions.

In Short

• Serve as subject matter expert for Medicare Secondary Payer compliance.
• Assist with EDI reporting requirements.
• Ensure compliance with federal and state regulations.
• Work closely with claims, legal, and compliance teams.
• Generate and submit required reports to Medicare.
• Manage and resolve EDI errors.
• Conduct training sessions on EDI requirements.
• Assist with quarterly audits for compliance.
• Proactively identify compliance risks.
• Maintain internal logs and audit trails.

Requirements

• 8-12 years of experience in workers' compensation compliance, Medicare reporting, or EDI processes.
• Deep expertise in MSP regulations and MMSEA Section 111 requirements.
• Advanced knowledge of EDI standards and reporting requirements.
• Experience with CMS systems, particularly COBSW.
• Strong understanding of workers' compensation regulations across jurisdictions.

Benefits

• Competitive cash compensation.
• Equity opportunities.
• Comprehensive health plans.
• Generous PTO.
• 401k match.
• Parental and caregiver leave.