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
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 as needed
Participate and communicate in daily account management team conference calls/meetings to discuss adjustment requests
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

health-related benefits including medical, vision, dental, and well-being and behavioral health programs
401(k)
company paid life insurance
tuition reimbursement
a minimum of 18 days of paid time off per year
paid holidays
annual bonus plan

Financial Operations Analyst

Key skills