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The Technical Operations Specialist role is a critical position at Platinum Care Management, responsible for setting up and maintaining electronic file feeds using EDI tools. This individual will provide day-to-day support for the Application Development team, focusing on research and resolution of data record errors and establishing contact with data-trading partners to correct failures.
This role requires effective communication with internal employees and external partners. The Technical Operations Specialist will wear many hats, with essential knowledge in the following areas:
- Collaborating with Operations to address technical issues arising from improper enrollment or enrollment changes on EDI files
- Analyzing claims, accumulator import/export files, and eligibility files mappings
- Performing daily, monthly, and quarterly audits of claims, eligibility, and accumulator data
- Loading files into the operations system
- Communicating ongoing task status to end-users and supervisors
- Adhering to departmental standards and procedures
- Troubleshooting operational inquiries
