Technical Operations Analyst
C
Crumdale SpecialtyHealthcare Insurance
United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 5+ years
- Required Skills
- SQL
Requirements
- 5+ years of experience in TPA operations, healthcare data operations, EDI, or technical operations.
- Strong experience managing inbound/outbound file processing across multiple vendors.
- Advanced SQL skills required (data extraction, transformation, reconciliation, reporting).
- Experience with file formats such as 834, 835, 837, CSV, flat files, JSON.
- Hands-on experience with SFTP platforms and file automation workflows.
- Strong understanding of TPA ecosystem (eligibility, claims, accumulators, PBM, network integrations).
- Proven ability to troubleshoot complex data and file issues across systems and partners.
- Strong analytical mindset with attention to detail and data accuracy.
- Excellent communication skills with both technical and non-technical stakeholders.
Responsibilities
- Own all inbound and outbound file processes across vendors (PBM, networks, medical management, etc.).
- Monitor, validate, and reconcile daily file activity (eligibility, claims, accumulators, EOBs, etc.).
- Troubleshoot and resolve file failures across SFTP connections, vendors, and internal systems.
- Serve as the primary technical contact for vendor file integrations and manage connectivity.
- Build, maintain, and enhance operational and client-facing reports using SQL.
- Perform cross-system data audits between claims system, vendor outputs, and internal reporting.
- Support new client implementations from a file and reporting readiness perspective.
- Develop and maintain SOPs for file management, error handling, and reporting processes.
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