Crumdale Specialty

insurance

TechnicalOperationsAnalyst

United States FULL TIME Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid candidates.

The Brief

“Technical Operations Analyst at Crumdale Specialty. Skills: File Operations, Vendor Integration, Reporting, Data Quality. Own inbound and outbound file processes. Monitor, validate, and reconcile daily file activity”

What You'll Achieve.

Ensuring accurate, timely, and scalable data exchange across all partners; Support the evolution of a scalable TPA operating model as client and vendor volume grows

Industry & Context.

insurance
Problems you'll solve

Troubleshoot and resolve file failures across SFTP connections, vendors, and internal systems; Coordinate with vendors and claims system to resolve discrepancies, mapping issues, and data inconsistencies; Identify and resolve root causes of data discrepancies (eligibility, claims, accumulators)

What They're Looking For.

Must Have

5+ years of experience in TPA operations, healthcare data operations, EDI, or technical operations, 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, Understanding of TPA ecosystem (eligibility, claims, accumulators, PBM, network integrations), Proven ability to troubleshoot complex data and file issues across systems and partners, Analytical mindset with attention to detail and data accuracy, Excellent communication skills with both technical and non-technical stakeholders

What You'll Do.

Own inbound and outbound file processes

and reconcile daily file activity

Ensure proper file formatting

Troubleshoot and resolve file failures

Maintain and optimize file workflows

Serve as primary technical contact for vendor file integrations

Manage connectivity across SFTP platforms

Coordinate with vendors and claims system

Ensure alignment between vendor requirements and internal system capabilities

and enhance operational reports using SQL

Translate business and client reporting needs

Support reporting across eligibility

Partner with internal teams for reporting insights

Perform cross-system data audits

Identify and resolve root causes of data discrepancies

Ensure consistency of data across systems

Develop processes to monitor data quality

Support new client implementations

Ensure vendor file connections are tested

Partner with leadership to meet deadlines

Assist in defining file requirements

Develop and maintain SOPs

Identify opportunities for automation

Support evolution of TPA operating model

How You'll Work.

Team & Collaboration

Partner with internal teams (Account Management, Claims, Finance) to deliver accurate reporting insights; Partner with implementation and TechOps leadership to meet critical deadlines and dependencies

Communication Scope

Excellent communication skills with both technical and non-technical stakeholders

Full Job Description

**About Crumdale Specialty** Crumdale Specialty is a diversified insurance firm providing custom, self-funded healthcare solutions to a limited distribution network 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. At Crumdale, people come first. Our culture is rooted in alignment, innovation, accountability, and integrity. **About the Role** We are hiring a Technical Operations Analyst to own inbound and outbound file operations, vendor data integrations, and reporting across our growing TPA environment. This role will serve as the central hub for file management, data movement, and operational reporting; ensuring accurate, timely, and scalable data exchange across all partners including networks, PBMs, and other vendors. This position is highly technical and data-focused, requiring strong SQL skills, deep understanding of TPA workflows, and the ability to translate business needs into reliable reporting and file solutions. **Key Responsibilities** 1. File Operations & Data Exchange Management * 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. 2. Vendor Integration Oversight * Serve as the primary technical contact for vendor file integrations. * Manage connectivity across SFTP platforms, APIs (where applicable), and vendor data exchanges. * Coordinate with vendors and claims system to resolve discrepancies, mappin

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