CVS Health Analyst-Pharmacy Account Management in Cumberland, Rhode Island
The primary responsibility of the Analyst - Pharmacy Account Management is to support the Third Party Account Management team to reduce bad debt, eliminate legal risk, and help ensure compliance to all federal/state requirements and CVS Health obligations.
You will focus on analyzing bad debt, determining root cause and making recommendations for process improvements with payers and/or CVS Health systems and processes
You will also perform analysis and root cause diagnosis on various Third Party activities including liabilities, and remittance exceptions. This function supports the goals of recognizing and controlling bad debt through process enhancements and focused efforts in the timely resolution of all exceptions.
The Analyst - Pharmacy Account Management is also responsible for performing trend analysis on Payer exceptions, reviewing reports and current procedures, identifying issues, recommending/implementing process improvements, and ensuring compliance.
In addition to supporting the Pharmacy Account Management team, this associate will coordinate files for write offs and will work closely with our system partners by attending requirement meetings/ reporting defects and following up on the resolution /recommending and writing change requests as well as implementing a short term solution. You will also need to be able to adhere to all HIPPA privacy guidelines.
1+ years of professional work experience required. Experience in retail pharmacy, PBM, banking/health insurance claims processing, or analyst experience strongly preferred
1+ years of MS Office experience
Excellent analytical and root cause diagnosis skills along with the ability to influence decisions by creating a strong case for action by leveraging analytical tools.
Strong problem resolution skills.
Ability to work individually or with a team to systematically identify and define problems, evaluate alternatives and implement practical, cost-effective solutions.
Ability to frame recommendations and formally present them to management.
Actively develops open and trusted relationships across the organization to gain efficiencies and drive decisions
Demonstrated ability to prioritize and organize work to accurately complete projects or assignments on schedule.
Ability to complete routinely assigned work based on productivity standards (SLA) with minimal supervision.
Ability to make intelligent decisions independently and collaboratively, contributing recommendations for resolution of issues.
Ability to maintain composure and perform job duties/responsibilities when confronted with stressful situations.
Proven ability to deliver accurate results. Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy, and follow through.
Possesses a working knowledge of laws and regulations relating to the billing/claims processing of health insurance claims to government and private payers.
Excellent verbal and written communication skills and the ability to interact professionally with a diverse group - directors, managers, colleagues and external entities.
Flexibility to adapt to a changing environment, quickly making sound decisions.
- Verifiable High School Diploma or GED required. Bachelor's degree strongly preferred.
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf and EEO IS THE LAW SUPPLEMENT at https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking EEO AA CVS Health at mailto:EEO_AA@CVSHealth.com
CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/