SQL Developer with Claims - Remote / Telecommute
CYNET SYSTEMS INC.
Mason, United States of America
2 days ago
Role details
Contract type
Permanent contract Employment type
Full-time (> 32 hours) Working hours
Regular working hours Languages
English Compensation
$ 62KJob location
Remote
Mason, United States of America
Tech stack
Data analysis
Batch Processing
Big Data
Database Queries
Database Storage Structures
Java Virtual Machine (JVM)
Data Streaming
Pega
Freeform SQL
ServiceNow
Job description
- Monitor and support end-to-end claims batch processing, pre-adjudication, and related data transfers.
- Investigate and analyze pre-adjudicated and impacted claims; determine root cause and recovery actions.
- Execute batch job re-runs, backfills, and recoveries following approved runbooks.
- Perform claims reconciliation activities and validate claim counts, dollar amounts, and processing outcomes.
- Provide on-call SME support for claims processing incidents and high-volume seasonal events.
- Monitor batch jobs and Tidal automation schedules for in-scope claims applications.
- Respond to monitoring alerts, initiate incident tickets, and escalate per operational procedures.
- Perform PEGA dashboard monitoring, JVM health checks, and application availability checks.
- Participate in incident bridges and SWAT calls, providing technical analysis and status updates.
- Use complex SQL queries to analyze claims data, investigate processing failures, and validate reconciliations.
- Support incident troubleshooting through data analysis and ad-hoc reporting.
- Partner with application teams to understand database structures supporting claims workflows.
- Log, triage, track, and manage incidents in ServiceNow through resolution.
- Assist with Root Cause Analysis (RCA) efforts for recurring or high-impact incidents.
- Track corrective and preventive actions to closure.
- Contribute to operational, SLA, and KPI reporting.
- Maintain operational documentation, runbooks, and knowledge articles.
- Identify opportunities for process improvement and automation.
Requirements
- Strong SQL skills with experience querying large, complex datasets.
- Experience supporting healthcare claims processing systems (e.g., Facets or similar).
- Understanding of batch scheduling, automation tools, and production monitoring.
- Familiarity with ServiceNow incident management.
- Ability to work effectively in a 24x7 production support environment., * Knowledge of EDI 837 transactions and claims data flows.
- Experience in regulated healthcare or government programs.
- Prior production support or operations experience in a claims environment.