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Technical Operations Analyst

Crumdale Specialty · United States · 3 wk ago
RemoteRemoteInformation TechnologyFull-time

About the role

We are hiring a Technical Operations Analyst to own inbound and outbound file operations, vendor data integrations, and reporting across our growing TPA environment. This role serves as the central hub for file management, data movement, and operational reporting.

Key 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.).

  • 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.

  • Coordinate with vendors and claims system to resolve discrepancies, mapping issues, and data inconsistencies.

  • Ensure alignment between vendor requirements and internal system capabilities.

  • Build, maintain, and enhance operational and client-facing reports using SQL.

  • Translate business and client reporting needs into scalable data solutions.

  • Support reporting across eligibility, claims, accumulators, and vendor data.

  • Partner with internal teams (Account Management, Claims, Finance) to deliver accurate reporting insights.

  • Perform cross-system data audits between claims system, vendor outputs, and internal reporting.

  • Identify and resolve root causes of data discrepancies (eligibility, claims, accumulators).

  • Ensure consistency of data across all downstream systems and vendor partners.

  • Develop processes to proactively monitor and improve data quality.

  • Support new client implementations from a file and reporting readiness perspective.

  • Ensure all vendor file connections are tested, validated, and operational prior to go-live.

  • Partner with implementation and TechOps leadership to meet critical deadlines and dependencies.

  • Aid in defining file requirements, layouts, and reporting needs for new clients.

  • Develop and maintain SOPs for file management, error handling, and reporting processes.

  • Support the evolution of a scalable TPA operating model as client and vendor volume grows.

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

At Crumdale, we strive to provide a comprehensive and supportive benefits package to ensure the well-being of our employees. Our benefits include:

  • Medical

  • Telemedicine

  • Dental

  • Vision

  • Life, AD&D, Disability

  • 401(k)

  • Flexible Time-off

Please note: Crumdale Specialty is not engaging with external recruitment agencies; please refrain from contacting us regarding this position.

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