Renewal and Reporting Analyst

CVS Health•Washington, NV

1d•$46,988 - $122,400

About The Position

Provides plan benefit review, interpretation, and systematic setup for online viewing and processing related to customer service, claims, enrollment, billing, and reporting, supporting internal and external partners. Uses Meritain’s proprietary system to analytically code detailed customized plans rather than standard offerings. Develops and executes implementation strategies consistent with client expectations and performance guarantee arrangements. Consults internal stakeholders on complex benefit administration and advises on ways to minimize manual processing and client disruption. Uses business knowledge to make plan design and processing recommendations when working with clients. Reviews benefit provisions for compliance with state and federal mandates, potentially assessing summary plan descriptions and related documents prepared internally or by clients. Collaborates on analyzing complex account and benefit structures and developing recommendations based on customer objectives and Meritain’s system. Sets up and maps client-level benefits to industry coding, including ICD 10, place of service, and healthcare reform requirements, in work described as similar to entry-level IT programming. Solicits and assesses customer feedback to improve the renewal process, including system tools and resources. Demonstrates Salesforce proficiency and understanding to support cross-functional communication and executive-level status reporting.

Requirements

At least 2 years of experience working with healthcare, specifically in quality, renewals, client advocacy, and/or account management.
Demonstrated knowledge of medical terminology.
Ability to work Monday through Friday, 8 a.m. to 5 p.m., and beyond those core hours during busy seasons.
High school diploma or GED.

Nice To Haves

At least 5 years of experience working with healthcare, specifically in quality, renewals, client advocacy, and/or account management, including demonstrated knowledge of medical terminology.
Previous experience with Salesforce.
Previous experience with various data systems, including DOS systems.
Ability to research beyond the first right answer to identify the root of a concern.
Strong analytical and problem-solving skills.
Ability to remain flexible and focused during stressful situations.
Strong communication skills, including the ability to express complex concepts clearly and concisely.
Excellent organization skills and ability to prioritize multiple assignments while producing high-quality results.
High attention to detail and accuracy while focusing on overall project deliverables.
Associate’s or Bachelor’s degree.

Responsibilities

Review, interpret, and set up plan benefits for online viewing and processing related to customer service, claims, enrollment, billing, and reporting.
Use Meritain’s proprietary system for analytical coding of detailed customized plans.
Develop and execute implementation strategies aligned with client expectations and performance guarantee arrangements.
Consult internal stakeholders on complex benefit administration and advise on ways to minimize manual processing and client disruption.
Make plan design and processing recommendations when working with clients.
Review benefit provisions for compliance with state and federal mandates, including assessment of summary plan descriptions and related documents.
Collaborate on reviewing and analyzing complex account and benefit structures and developing recommendations based on customer objectives and Meritain’s system.
Set up and map client-level benefits to industry coding, including ICD 10, place of service, and healthcare reform requirements.
Solicit and assess internal and external customer feedback to improve the renewal process.
Use Salesforce for cross-functional communication and executive-level status reporting.