Innovative Insurance Solutions. Better Benefits.
Technical Operations Analyst
Location
United States
Posted
2 days ago
Salary
0
Seniority
Senior
Job Description
Technical Operations Analyst
Crumdale Specialty
• 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.). • Ensure proper file formatting, delivery, acknowledgments, and error resolution. • Troubleshoot and resolve file failures across SFTP connections, vendors, and internal systems. • Maintain and optimize file workflows to support scalability and automation. • Serve as the primary technical contact for vendor file integrations. • Manage connectivity across SFTP platforms, APIs (where applicable), and vendor data exchanges. • 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. • Identify opportunities for automation, efficiency improvements, and standardization.
Job 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.
Benefits
- Medical
- Telemedicine
- Dental
- Vision
- Life, AD&D, Disability
- 401(k)
- Flexible Time-off
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