Senior Manager, Claims Technical Analyst, Medicaid Intake Operations
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
• 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:
• 5+ years of experience as a SQL Server power user (coding and developing data extracts)
• 5+ years of data interpretation and analysis experience
• 5+ years querying large datasets using SQL, SAS, or other data tools
• Strong documentation skills; writing readable and reproducible code
• Process improvement mindset; strives to simplify complex processes
• Proficient in Word, PowerPoint, Excel
• Experience working independently and prioritizing multiple deliverables
• Experience managing conflicting priorities and concurrent projects
• Excellent verbal and written communication skills with experience communicating technical information to non-technical audiences
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling
• Financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
Apply Now
Apply Now
• 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
• 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:
• 5+ years of experience as a SQL Server power user (coding and developing data extracts)
• 5+ years of data interpretation and analysis experience
• 5+ years querying large datasets using SQL, SAS, or other data tools
• Strong documentation skills; writing readable and reproducible code
• Process improvement mindset; strives to simplify complex processes
• Proficient in Word, PowerPoint, Excel
• Experience working independently and prioritizing multiple deliverables
• Experience managing conflicting priorities and concurrent projects
• Excellent verbal and written communication skills with experience communicating technical information to non-technical audiences
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling
• Financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
Apply Now
Apply Now