Senior Analyst - Remittance/Cash Reconciliation

Job DescriptionThe Cash Reconciliation Remittance Sr. Analyst is responsible for driving the Cash Reconciliation process to be as accurate and efficient as possible. This is accomplished through the identification of opportunities to streamline and automate remittance processes as well through the management of existing automated accounts. The Sr. Analyst ensures timely receipt and application of electronic remittance files by initiating, retrieving, monitoring, and working exceptions relating to the receipt and application of files from Payers. This role is responsible for immediate identification of any exceptions to normal remittance patterns, escalating and resolving those exceptions, understanding the impacts to other Operational and Financial areas, and for communicating the impacts clearly and timely. They will work with Payers to retrieve missing electronic files and/or to rectify any compliance related issues with remittance files (i.e. files that are out of balance, including incorrect/unacceptable characters, etc). In addition, the Cash Reconciliation Remittance Sr. Analyst will perform outreach to payers with the intention of converting them to use electronic remittance files and then facilitating the test and implementation efforts. Core Responsibilities include:-Ensure that electronic remittance files process via myriad methods from Third Party Payers while coordinating retrieval schedules whenever possible. Additionally, communicate to the payer and necessary CVS departments when a file was not provided per schedule.-Ability to work with TPMS system expertly; creating necessary setups and configurations, monitoring and resolving work queue items, and continually seeking process improvements.-Drive conversion of Payers to electronic remittance advice: complete necessary enrollment materials, partner with internal and external business partners, accurately test files, implement new setups, update ERA scheduling.-Schedule and run automation software to retrieve web portal downloads.-Manage Third Party setups for file retrieval including SFTP and other IT supported approaches. Coordinate efforts with mainframe and IT support teams when firewall settings and IP payer address changes occur.-Develop a deep understanding of Third Party processes.-Foster strong working relationships with Payers.-NCPDP involvement collaborating with industry leaders/stakeholders in order to create and promote standards for electronic healthcare transactions through a consensus-building process.-Perform remittance tracking against deposits.-Research and resolve cash reconciliation exceptions in a timely manner according to pre-determined SLAs.-Evaluate current processes and make recommendations to drive efficiencies.-Work with payers, IS, and account teams to resolve exceptions.-Evaluate unmatched remittance activity in partnership with AR team to help identify opportunities for mapping updates to increase our success rate for remit to claim matching.-Determine impacts to exceptions in remittance activity, understand the operational and financial impacts, and communicate the impacts to all relevant areas.Pay RangeThe typical pay range for this role is:Minimum: 43,700Maximum: 97,400Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications-1+ years of professional work experience in retail pharmacy, PBM, or banking/health insurance claims processing.-Excellent working knowledge of MS Office applications (such as MS Word, Excel, Access, and Outlook.)Preferred Qualifications-Familiarity with data mining tools, Database Access Tools (Toad, SQL Developer, Teradata) preferred.-Ability to complete routinely assigned work based on productivity standards (SLA) with minimal supervision and adherence to established Standard Operating Procedures.-Proven ability to work in strict confidence, ensuring the confidentiality of patient, medical and financial records and abide by the policies, procedures, guidelines and trainings required for position. -Flexibility to adapt to a changing environment, quickly making sound decisions and the desire to seek continued professional growth.-Excellent verbal and written communication skills and the ability to interact professionally with internal/external business partners (i.e. directors, managers, colleagues and external entities.)-Demonstrated aptitude to work individually or with a team to systematically identify root cause, define problems, evaluate alternatives and recommend/implement viable solutions.-Confirmed capability to deliver accurate results. Analytical mindset, critical thinking, organizational, and time management skills with a strong attention to detail, accuracy, and follow through while organizing and prioritizing work autonomously to ensure focus on high impact/value added activities.-Fosters creative thinking by bringing colleagues together from various parts of the company for problem solution. Proven ability to understand the big picture and drive innovation for defining scope for business solutions. -Excellent financial acumen - understands how decisions and issues impact Reserves, Cash Flow, Bad Debt, and other budget line drivers.-Propensity to work collaboratively with cross-functional teams on projects that impact Third Party, document and train associates on processes/procedures.EducationVerifiable Bachelor's degree or equivalent work experience required.Business OverviewBring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2024-10-19