Medical Account Analyst, Revenue Cycle

$43,888 - $93,575/Yr

CVS Health - Providence, RI

Full-time - Entry Level

Providence, RI

Health and Personal Care Retailers

About the position

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. The primary responsibility of the Third Party Medical Account Analyst is to support the Third Party Medical Account Management team to reduce bad debt, eliminate legal risk, and help ensure compliance to all federal/state requirements and CVS Health obligations. The TP Medical Analyst will be responsible for performing trend analysis on payer exceptions, liabilities, reviewing reports and current procedures, identifying issues, recommending/implementing process improvements, and ensuring compliance. The TP Analyst will work closely with Third Party Medical Account Management team, as well as other internal and external partnerships for the implementation of process enhancements resulting in short/long term resolutions.

Responsibilities

• Support the Third Party Medical Account Management team to reduce bad debt and eliminate legal risk.
• Perform trend analysis on payer exceptions and liabilities.
• Review reports and current procedures to identify issues.
• Recommend and implement process improvements to ensure compliance.
• Collaborate with internal and external partnerships for process enhancements.

Requirements

• Prior work experience from 1 to 3 years in retail pharmacy, PBM, banking/health insurance claims processing, or analyst roles.
• Strong analytical, critical thinking, organizational, and prioritization skills with attention to detail.
• Ability to work individually or with a team to identify and define problems and implement solutions.
• Excellent verbal and written communication skills to develop relationships across the organization.
• Ability to maintain confidentiality of patient and medical records in compliance with HIPAA guidelines.
• Flexibility to adapt to a changing environment and make sound decisions quickly.
• Proficiency in MS Operating Systems and MS Office applications (Word, Excel, Access, Outlook).
• Structured Query Language (SQL) skills and experience with data mining tools.

Nice-to-haves

• Experience with MicroStrategy or other data mining tools.
• Creative thinking and self-starter attitude with limited guidance.

Benefits

• 401(k)
• Dental insurance
• Disability insurance
• Employee discount
• Employee stock purchase plan
• Health insurance
• Life insurance
• Paid Time Off (PTO)
• Paid holidays
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses