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.

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.

Manager, Claims Technical Analyst – Medicaid Intake Operations

Key skills