Manager, Claims Technical Analyst – Medicaid Intake Operations

Remote Full-time
Job Description: • Serve as the Technical Subject Matter Expert (SME) for intake rules and matching logic • Liaise with providers and internal teams to resolve questions about EDI and Claims Intake rejections • Provide second-level expert support for intake claim rejections • Analyze large datasets for research and troubleshooting • Collaborate with Product Owners and IT teams on system enhancements and fixes • Participate in testing and verification of business rules and validations • Manage multiple projects and tasks simultaneously while maintaining high-quality results • Support Product Owners, Business Owners, and Leads using technical and analytical expertise • Communicate effectively across all levels of the organization, including cross-functional teams • Write complex SQL queries to join multiple data sources and analyze data for root causes, trends, and opportunities • Lead the creation of automated reporting solutions using Tableau, Excel, and other tools to deliver actionable insights • Translate complex data analysis into clear, actionable information for non-technical audiences • Analyze EDI and Claims intake rejections from internal and external inquiries, including provider calls • Track and execute solutions for identified issues • Perform User Acceptance Testing for logic changes and enhancements • Develop utilities, queries, and processes for post-production checkout of business rules and system fixes Requirements: • 3–5 years of experience as a SQL Server power user (coding and developing data extracts) • 5+ years of data interpretation and analysis experience • 4+ years working with data visualization tools (Tableau, Power BI, or equivalent) • expertise in data storytelling and preparing data for presentation in Excel and PowerPoint • 5+ years querying large datasets using SQL, SAS, or other data tools • strong documentation skills; writes readable and reproducible code • proficient in Word, PowerPoint, Excel • self-starter with the ability to work independently and prioritize multiple deliverables • demonstrated ability to manage conflicting priorities and concurrent projects • excellent verbal and written communication skills, able to communicate technical ideas to non-technical audiences • strong problem-solving, analytical, and critical thinking skills Benefits: • medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility
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