Healthcare Encounter Senior Analyst

CVS Health•Work At Home-Arizona, AZ

3d•$46,988 - $122,400

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. As a Healthcare Encounter Analyst - Senior for claim reconciliation in the State Medicaid Encounters department, you will work exclusively with Pharmacy generated Medicaid encounters. You will be responsible for researching, analyzing and correcting previously submitted, rejected, Medicaid encounters. A self starter with a natural curiosity and a high attention to detail would be well suited for this role, as many potential issues and creative solutions, to those issues, have not been identified yet. This research includes, but is not limited to, examining setups/configurations as well as comparing text files and their contents to identify trends or issues with the integrity of the data within those files. Many innovative solutions are driven from this research and curiosity. You will also be responsible for serving a select group of clients. You will be responsible for maintaining, and in some cases developing, a relationship with key parties on the client side. Part of developing/maintaining a great working relationship with each client will include providing recurring metric reports to keep the client up to date. For the most part, these metrics are produced from SAS, and a proprietary version of AS400. Experience with either of these systems or prior exposure to the PBM or Medicaid industry would be advantageous. The ability to think critically and multitask is very valuable in this role. Additionally, you will be an integral part of recurring client meetings. You must be comfortable and adept with clearly communicating technical information (verbal and written) to non technical people and leading conference calls, when needed. As part of our CVS Health team, you will be empowered to make decisions and think outside of the box, as we truly value innovation. Our team has expanded rapidly and will provide room for growth in the future. This is an excellent opportunity to be part of a multi-functional team which treats each other like family.

Requirements

1+ years of professional work experience with data analysis.
2+ years of experience using Excel in a professional or academic setting.
High school diploma/GED required.

Nice To Haves

3+ years of professional work experience, preferably in a related field such as data analysis.
Previous Medicaid Encounter experience and/or PBM experience
3+ years experience with Excel
Strong problem solving skills with the ability to work independently
Great communication skills, as the position will involve communicating with clients
Bachelor's degree preferred.

Responsibilities

Researching, analyzing and correcting previously submitted, rejected, Medicaid encounters.
Examining setups/configurations as well as comparing text files and their contents to identify trends or issues with the integrity of the data within those files.
Serving a select group of clients.
Maintaining, and in some cases developing, a relationship with key parties on the client side.
Providing recurring metric reports to keep the client up to date.
Being an integral part of recurring client meetings.
Clearly communicating technical information (verbal and written) to non technical people.
Leading conference calls, when needed.