Analyst, Pharmacy Financial Operations
About The Position
About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx , a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™ , which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit www.judi.health . Position Summary: The Analyst, Finance Operations position is a hands-on position responsible for managing the day-to-day operations and activities of the finance team. The Analyst, Pharmacy Financial Operations should be highly motivated, have a positive team attitude, and support the overall organization.
Requirements
- Bachelor’s degree in accounting, Finance, Data Science, or a related field (or equivalent relevant work experience).
- 2+ years of experience in PBM with exposure to claims, payments, and remittances.
- Strong SQL proficiency is required, including ability to write queries and perform data validation.
- High proficiency in Microsoft Excel, including advanced functions, pivot tables, lookups, and data accuracy checks.
- Strong analytical and problem-solving skills.
- Exceptional attention to detail, especially in data checks, reconciliations, and validation steps.
- Excellent communication and interpersonal skills.
- Ability to work independently and collaboratively in cross‑functional teams.
- Knowledge of healthcare compliance regulations is a plus.
Nice To Haves
- Experience with Sage software for managing payment processes and financial reconciliations.
- Python knowledge is a plus but not required for this role.
Responsibilities
- Review, analyze, and reconcile pharmacy claims and payments data.
- Configure vendors for payment processing in our financial system.
- Verify and ensure that all vendors possess all required credentials.
- Ensure accurate and timely processing of pharmacy, member, and provider payments and remittances.
- Collaborate with pharmacy network partners to resolve payment-related inquiries.
- Investigate and resolve payment discrepancies and variances.
- Develop and maintain strong relationships with pharmacies, providers, and reconciliation companies.
- Prepare and distribute paper or electronic (835) remittances and reports.
- Manage the reissuance of checks for voided or reprocessed payments.
- Monitor and report on key performance indicators related to payment accuracy and timeliness.
- Ensure compliance with state regulations by submitting unclaimed funds to the state.
- Participate in the development and implementation of financial policies and procedures.
- Assist in financial audits and provide documentation as needed.
- Stay up to date with industry standards and compliance requirements.
- Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
- Write SQL queries to retrieve specific Pharmacy files from the data warehouse as needed.
- Respond to internal and external inquiries regarding payment data, providing clear and actionable insights.
- Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
