Urgent Hiring - Excellent Pay!
***FULLY REMOTE-- NEVER COMING ON SITE-- EQUIPMENT SHIPPED***
The Data Analyst Financial Operations role performs claims reverse and reprocessing RR functions to address benefit coding errors eligibility changes program features and client requests.
This reprocessing is a vital step in the Adjustment or Service Warranty process. This activity touches millions of claims a year and has wide organizational impacts. The primary responsibilities are as follows: Follow up on cases in SalesForce workflow program on cases in different statuses- pending Requestor Approval status Rejects/QA fails that are aging with the Account Team missing sub-status missing financials. Work through our claim reversal case process from start to finish Work through claim submit case process from start to finish Assist analysts with working basic claim Rejects and QA fails on Express cases Run standard team reports: Pharmacy Adjustment Collection Log NDC and Pharm 10 reporting systems Assist in creating claim submission files VBRx files for Pharmacy Adjustment cases Send internal approval templates Benefit Validation BV approval templates Assist with member check suppression requests process Update case status to On Hold and send out Chatter message when internal auditor rejects Validation Report VR Review Case Resolution Log and take appropriate action to close out cases Submit daily releases for the team Run PA Query Macros VB Compound COBs Adhoc requests as needed increase in quantity and complexity depending on skillset and progress during assignment This role is required to manage multiple responsibilities in a fast-paced process-driven environment. Attention to detail excellent communication and time-management skills are essential.
-- 1 years of analytical experience with large data sets
-- 2 years of Microsoft Excel specifically vlookup pivot tables and data manipulation.
-- Read and understand Excel Macros