Manager, Claims Technical Analyst – Medicaid Intake Operations
Posted 2026-05-06
Remote, USA
Full-time
Immediate Start
- 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