Technical Operations Analyst

🕒 May 27

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Crumdale Specialty

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

⚕️ Healthcare Insurance

💸 Finance

Healthcare Insurance • Finance • Insurance

Crumdale Specialty is a diversified insurance firm providing custom, self-funded healthcare solutions to a bespoke set of brokers, consultants, and agents nationwide. Ranked on the Inc. 5000 Fastest Growing Companies and Best Workplaces, we leverage industry expertise, superior talent, data analytics, and a disruptive mindset to manufacture, underwrite, and administer agile, transparent, and cost-saving solutions. We optimize the fragmented health benefits supply chain to reduce health benefit costs and create better outcomes for employers and employees, offering integrated health plans, stop loss group captives, and pharmaceutical benefit solutions.

📋 Description

• 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.

🎯 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