Business Analyst

  • Location
    Irvine, California
  • Job type
    Contract/Temporary
  • Salary
    $ 25 - $ 34 / Hour
  • Category
    Medical & Science

***Actual Job Title: Senior Payment Analyst***

The responsibilities of this position include, but are not limited, to the following:

1. Oversees and manages the production schedules for pharmacy payment batches, tracer activity, projects and reporting. These activities are performed by onshore and offshore team members.

2. Perform account reconciliations and analyses

3. Assists on external and internal audits

4. Generate standard and ad hoc reports as required

5. Develop innovative approaches for continued improvement in efficiency and effectiveness.

6. Assist with complex reconciliations that involve Billing and Payment data. In addition, perform, analyze and report on findings of the reconciliation

7. Assist with running and analyzing reports from claims data warehouse, RxC online reporting tools, MS Access & Excel

8. Partner with other departments, including Retail Network Ops, Provider Relations, Claims Operations and IT for payment batch/checks monitoring, payment tracer questions and other ad hoc processes

9. Reviews weekly RXACH schedules and payment files

10. Performs network audit payment hold activities

11. Assists in creating yearly payment schedules

12. Performs key SOX controls for pharmacy payment accuracy, completeness and cutoff

13. Performs weekly unclaimed and abandoned property activities

14. Prepares reporting for client performance guarantees and CMS/state regulators for prompt pay compliance

15. Provides payment backup support for COGS/Claim Payable and billing / revenue Blackline recons

16. Other related duties as assigned

 

Requirements:

1. Minimum of 3-5 years of professional experience in business management, finance, accounting, or related function

2. Bachelor degree in business administration/management, accounting, finance, or related function

3. The ideal candidate would have healthcare background

4. Data mining/query, analytics, MS office experience is a plus and/or willingness to learn is desired

5. Proficiency with Excel is required, Advanced skills a plus

6. Strong verbal and written communication skills as the position requires interfacing with other departments and clients

7. Strong analytical skills; detail oriented, as well as ability to see `big picture 

8. Ability to work and contribute in a team environment, as well as work independently

9. Takes initiative and accountability for work product and able to meet deadlines

10. Serves as a key resource on complex and/or critical issues

11. Solves complex problems on own; proactively identifies new solutions to problems

12. Plans, prioritize, organize and complete work to meet established objectives

 

Shift Start/End Time: 7:30am - 4:30pm or 8:00am to 5:00pm PT

Dress Code: Business Casual

Work Location:  Irvine, CA 



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Reference number US_EN_99_028082_11909809