Associate Financial Operations Analyst
Abarca Health
- San Juan, PR
- Permanent
- Full-time
- Execute client billing and provider payment processes; includes the related analysis, controls, and reconciliations.
- Responsible for invoice submission to client, payment issuance to providers and solving any issues or concerns to ensure client satisfaction.
- Monitor Direct Members Reimbursements (DMRs) and adjustments to approve, as applicable.
- Support on handling pharmacy appeals, assuring compliance with contractual timeliness requirements.
- Support any client and/or pharmacy concerns and ensure resolution and satisfaction.
- Handle clients' billing and payment inquiries in a timely manner.
- Identify and proactively suggest any margin for opportunities/risks or situations.
- Periodically and systematically reviewing and analyzing discrepancies and errors as needed.
- Provide recommendations and solutions for business process improvements.
- Provide support to the Medicare Reporting Requirements tasks and reconciliations, as well as other reporting requirements for other lines of business such as Commercial, Medicaid, among others.
- Provide client support and collaborate in special projects and activities as assigned.
- Bachelor's or Master's Degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
- 1+ years of experience in an analytical, finance, accounting, or auditing role.
- Experience working with financial reports and analysis utilizing dashboard tools - Intermediate or Advance Microsoft Excel, Tableau, and additional reporting tools.
- Experience in reviewing reports and data to spot discrepancies and issues.
- Excellent oral and written communication skills.
- We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only)
- Experience in healthcare or PBM is a plus.
- Experience or knowledge working with SQL.
- Must be able to access and navigate each department at the organization's facilities.
- Sedentary work that primarily involves sitting/standing.