Healthcare IT Technical Operations Associate III

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $70k - $88k / year

⏰ Full Time

🟡 Mid-level

⚙️ Operations

🦅 H1B Visa Sponsor

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Investigate and triage job failures, fallouts, and reprocessing requests raised by L1 • Analyze application logs, database queries, monitoring tools, and upstream/downstream dependencies to support root cause identification • Collaborate with L3, product, and other stakeholders to drive resolution • Execute data correction and reprocess failed or fallout records • Validate outcomes after reprocessing • Support preventive actions for recurring failures • Perform record count and detailed reconciliation across files, tables, messages, and interfaces • Analyze and resolve record count mismatches, data mismatches, duplicates, missing transactions, and out-of-balance conditions • Define and enhance reconciliation controls and validation checkpoints • Maintain reconciliation logs and audit trails • Analyze inbound and outbound interface issues • Coordinate with external vendors, trading partners, and upstream/downstream teams • Provide functional guidance to L1 and review L1-raised tickets • Contribute to runbook and SOP updates • Publish periodic reports on reconciliation status, fallout and reprocessing volumes, and SLA performance • Document and communicate open activities, pending reconciliations, and business-critical risks during shift handover • Identify recurring failures, support permanent fixes, and recommend automation opportunities • Contribute to best practices and process standardization across interfaces

🎯 Requirements

• Bachelor's degree in Computer Science, Information Technology, or a related field • Minimum 3-4 years of experience in application support, technical operations, or production support roles • Experience with healthcare platforms such as HealthEdge, Facets, or QNXT • Experience with healthcare data formats such as EDI X12 (270/271, 276/277, 834, 835, 837) • Ability to clearly communicate with external customers • Experience with production monitoring tools for investigation and support • Experience with ITSM tools such as Jira or ServiceNow • Hands-on experience with SQL for data validation, log analysis, and reconciliation queries • Solid understanding of incident management, SLA tracking, and escalation processes • Strong analytical skills with attention to detail • Familiarity with monitoring tools such as Dynatrace • Basic scripting knowledge for log review or automation • Awareness of ITIL practices • Understanding of US healthcare workflows including claims processing, member enrollment, and provider interactions • Familiarity with HIPAA compliance and healthcare data security standards • Candidates may be required to go through a pre-employment criminal background check • Must work remotely within the US

🏖️ Benefits

• Remote work environment • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity employer committed to workforce diversity