Renewal and Reporting Analyst

CVS Health•Washington, NV

20h•$46,988 - $102,000

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, in support of internal and external partners. The role 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 and advises internal stakeholders on complex benefit administration, options to minimize manual processing and client disruption, and plan design and processing recommendations. Reviews benefit provisions for compliance with state and federal mandates, which may include evaluating summary plan descriptions and related documents. Collaborates on the review, analysis, and development of recommendations for complex account and benefit structures based on customer objectives and Meritain’s system. Sets up systems and maps client-level benefits to industry coding, including ICD 10, place of service, and healthcare reform requirements. Gathers and assesses customer feedback to improve the renewal process and demonstrates Salesforce proficiency 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, with demonstrated knowledge of medical terminology.
Previous experience with Salesforce.
Previous experience with various data systems, including DOS systems.
Ability to research beyond the first apparent 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 explain complex concepts clearly and concisely.
Excellent organization skills and ability to prioritize multiple assignments quickly while maintaining 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 systematically set up plan benefits for customer service, claims, enrollment, billing, reporting, and online processing.
Use Meritain’s proprietary system to analytically code detailed customized plans.
Develop and execute implementation strategies consistent with client expectations and performance guarantee arrangements.
Advise internal stakeholders on complex benefit administration and options to minimize manual processing and client disruption.
Recommend plan designs and processing approaches 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 analysis and recommendations for complex account and benefit structures based on customer objectives and Meritain’s system.
Set up systems 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.