Financial Operations Analyst

Responsibilities

• Process mass adjustment requests from clients, account teams and/or functional areas.
• Analyze and audit adjustment requests due to claims processing issues, conduct detailed audit of system set up to ensure accuracy of the client’s claims adjustment requests and ‘before and after’ analysis of the claims re-price files.
• Prepare and produce an adjustment report to assigned business unit.
• Extract claims based on the requirements provided by the assigned business unit.
• Ensure requirements received in mass adjustment requests are accurate.
• Follow up with assigned business unit (i.e., Account Management) as needed.
• Participate and communicate in daily account management team conference calls/meetings to discuss adjustment requests and ensure issues are addressed in a timely manner.
• Ensure all documentation is maintained for audit purposes.
• Coordinate all financial upload files on a daily basis.
• Conduct special projects as assigned.

• Bachelor's degree in Finance, Accounting, Statistics, Business or other related field or equivalent work experience
• 2+ years relevant experience in finance, claims adjudication, or project management preferred
• Experience in Healthcare, Insurance, Pharmacy, or PBM industry highly preferred
• Proficiency with Microsoft Word, Office, Excel, including experience with large data sets, pivot tables, VLookup, and macros
• Experience with Power BI and Tableau a plus