Insurance AR Resolution Analyst, Revenue Cycle

Location: New Hampshire

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary CVS Health Third-Party Revenue Cycle Management (RCM), supporting CVS Retail pharmacies, has an opportunity for a full-time Insurance AR Resolution Analyst. As an RCM Analyst, you will perform advanced, payer-level analysis to support Third Party Account Management in maximizing collections, reducing bad debt, and ensuring compliance with federal, state, and CVS Health requirements.

This role focuses on identifying systemic drivers of payer exceptions, over payments, liabilities, and remittance issues through trend analysis, root cause diagnosis, and data validation. The analyst produces clear, leadership-ready insights and recommendations that drive short- and long-term operational improvements across Commercial and Medicaid  addition to supporting the Pharmacy Account Management team, this analyst will coordinate files for write offs and will work closely with our system partners by attending requirement meetings, identify and report defects as well as follow up on the resolution, and recommend and write requests to streamline current processes.

Success in this role requires analytical thinking, attention to detail, and the ability to follow established procedures while exercising judgement to escalate or recommend resolution paths as appropriate. As part of the account management team, you will work in a fast paced and team focused environment to ensure timely and accurate AR resolution.

We will support you by offering the tools and resources you need to be successful in a collaborative environment.

Essential Qualifications and Functions Apply advanced analytical and statistical techniques to identify root causes of Third-Party payer issues

Validate data accuracy and completeness using SQL and internal reporting tools

Translate complex findings into clear, actionable recommendations for leadership

Collaborate cross-functionally to prevent recurrence of payer issues

Maintain regular and predictable attendance and perform additional duties within role scope

Required Qualifications Knowledge of:

Third Party Revenue Cycle operations, payer behavior, and liability resolution

Commercial and Medicaid payer environments

Skill in:

Advanced analytical and root cause diagnosis techniques

Solid working knowledge of all MS Operating Systems and MS Office applications (MS Word, Excel, Access, PowerPoint), and process mapping software such as Microsoft Project and VisioSQL and data-mining tools to validate and reconcile financial data Familiarity with Micro Strategy, SQL, and other data mining tools

Developing leadership-ready documentation and recommendations

Ability to:

Independently evaluate complex problems and recommend effective solutions

Influence decisions through data-driven insights rather than authority

Prioritize and organize work to accurately complete projects or assignments on schedule

Work individually or with a team to systematically identify and define problems, evaluate alternatives and implement practical, cost-effective solutions

Frame recommendations and formally present them to management

Work with sensitive financial and patient data in compliance with HIPAAMaintain composure and perform job duties/responsibilities when confronted with stressful situations

Maintain excellent verbal and written communication skills and the ability to interact professionally with a diverse group
-directors, managers, colleagues, and external entities

Work in strict confidence, always ensuring the confidentiality of the patient and medical and financial records, in compliance with company and HIPAA Privacy guidelines

Operate effectively in ambiguous or evolving environments

Preferred Qualifications Accounts receivable or payer-facing experience

Experience supporting system…