Reporting Analyst, PFM Exceptions Management

Inmar Intelligence•Winston-Salem, NC

11d•Onsite

About The Position

Under the direction of a Supervisor, the Reporting Analyst in PFM Exceptions Management works directly with the client to manage the past due balances of the client’s third-party prescription receivables. The Reporting Analyst performs detailed analysis to identify missing payment or data opportunities and is responsible for pursuing those opportunities by contacting Pharmacy Benefit Managers (PBM’s), industry payers and other third-party processors on behalf of clients in order to meet contractual agreements. Duties also include assisting with on-boarding of new clients, cross-training with other team members, developing and improving operating processes, monitoring system processes, recommending product enhancements and system testing.

Requirements

At least four years of relevant experience involving customer service, computer usage, data entry and data analysis and a Bachelors’ degree in Business Administration, Accounting, or a related field: OR an equivalent combination of training and experience required to complete the essential functions/job responsibilities of the position
Knowledge of generally accepted accounting principles
Knowledge of accounting procedures on automated systems
Intermediate-level proficiency using MS Excel and MS Word
Knowledge of computer systems and report generation (AS/400 knowledge preferred)
Knowledge of servicing business accounts
Regularly required to use hands to finger, handle or feel objects, tools or controls, and reach with hands or arms.
Regularly required to talk or hear and read instructions on a computer monitor and/or printed on paper.
Regularly required to view items at an extremely close range and must be able to adjust and readjust focus.
Candidates must have authorization to work in the U.S. without the need for employer sponsorship now or in the future.

Nice To Haves

AS/400 knowledge preferred

Responsibilities

Analytical Research and resolve open claims by comparing unapplied cash
Perform open claims-to-cash comparisons for trending and routine clean-up recommendations
Contact industry players via phone and e-mail to facilitate action, developing follow-up strategy and documenting activity/results for clients
Utilize Pharmacy Financial Management (PFM) to aid in analysis, tracking results and pending efforts
Develop additional tracking methods to report analysis results in multiple formats and business case scenarios
Operational Facilitate conference calls and/or face-to-face meetings with clients
Create detailed spreadsheets or charts to present trending results
Make recommendations to clients for business rules based on professional judgment and accounting practices
Identify opportunities for improvement to client pharmacy operations to minimize unresolved or overstated balances
Develop analysis methods to quickly identify collection opportunities and maximize results
Develop best practices/standard reporting for client and internal communication
Administrative Identify system enhancements and working with IT/Product to define, implement and test enhancements
Meet client service level agreements related to collection practices and write-off percentages
Review details of exceptions management process/methodology
Manage day-to-day client relationships
Present cost/time savings estimates and final results
Assist account team with business review presentations
Maintain HIPAA (Health Insurance Portability and Accountability Act) compliance in all client communication
Inform team members and management on client cases, successes, and current inquiries
Cross train other associates to be backup when out of the office
Influence Review exceptions management service by discussing Inmar and client’s responsibilities
Recommend guidelines and best practices for business rules
Establish industry contacts and communication methods
Perform special projects and other duties as assigned by management