Reporting Analyst, PFM Exceptions Management

2 days ago

WinstonSalem, United States Inmar Full time
Position Summary:

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.

Primary Accountabilities:
  • 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
Required Qualifications:
  • 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
Individual Competencies:
  • Adaptable: Responds to change with a willingness to learn new ways to accomplish work.
  • Teamwork: Builds relationships and works cooperatively with others, inside and outside the organization, to accomplish objectives to build and maintain mutually beneficial partnerships, leverage information and achieve results.
  • Analytical and Critical Thinking: Ability to tackle a problem by using a logical, systematic, sequential approach.
  • Communication: Giving and receiving messages and information in written, oral, and visual formats in a clear and concise way for a complete understanding of meaning and intent.
  • Curious: A desire to inquire and learn, to seek new knowledge and wisdom, and to listen to the contributions of others with a genuine interest to better self, the team, and the organization.
  • Problem Solving: Gathers and analyzes information to generate and evaluate solutions to problems, issues and challenges while weighing the accuracy and relevance of the facts, data and information.
  • Collaboration: Works collaboratively with others to achieve group goals and objectives.
The physical demands described here are representative of those that must be met by an associate to successfully perform the major job responsibilities (essential functions) of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the major job responsibilities. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.

While performing the duties of this job, the associate is:
  • 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.
  • Occasionally required to stand, kneel or stoop, and lift and/or move up to ## pounds.
  • Regularly required to view items at an extremely close range and must be able to adjust and readjust focus.
Occasionally: Job requires this activity up to 33% of the time

Frequently: Job requires this activity between 33% - 66% of the time

Regularly: Job requires this activity more than 66% of the time

Safety:
  • Support a safe work environment by following safety rules and regulations and reporting all safety hazards.
As an Inmar Associate, you:
  • Put clients first and consistently display a positive attitude and behaviors that demonstrate an awareness and willingness to listen and respond to clients in order to meet their short-term and long-term needs, requirements and exceed their expectations.
  • Treat clients and teammates with courtesy, consideration and tact; you also have the ability to perceive the needs of internal and external clients and communicate effectively with the objective of delighting and retaining the client.
  • Build collaborative relationships and work cooperatively with others, inside and outside the organization, to accomplish objectives, develop and maintain mutually beneficial partnerships, leverage information and achieve results.
  • Set and attain achievable, yet aggressive, goals with a sense of urgency and accountability.
  • Understand that results are important and focus on turning mission into action to achieve results following the principles of Flawless Execution while consistently complying with quality, service and productivity standards to meet deadlines and exceed expectations by giving our clients the best possible outcomes.


#LI-BA1

We are an Equal Opportunity Employer, including disability/vets.

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