Develop team-specific KPI dashboard and conduct periodic analyses of financial results to identify positive/negative trends, operational opportunities, etc.
Identify automation opportunities and partner with Fin Ops management and Strategic Operations to assess ROI, develop requirements, and prioritize projects based on importance and impact
Obtain working knowledge of and assist in all invoicing aspects:
Lead comprehensive billing processes by analyzing inbound data from multiple sources, including multi-year contracts, client programs, and service volumes (e.g., per claim, per member, one-time fees, recurring fees)
Manage billing across various lines of business including commercial, public, private, and government health plans, covering drug spend and ancillary services
Invoice Generation: Prepare and issue invoices based on predefined billing schedules and contract terms
System Reconciliation: Reconcile billing records between internal platforms (e.g., ERP and adjudication systems) to ensure consistency
Contractual and Clinical Program Reconciliation for Billing: enhance reconciliation process to ensure and confirm all billable programs and administrative fees are correctly captured
Audit Support: Assist with internal audits by providing technical or analytical support on requests
Process Adherence: Follow established billing procedures and escalate discrepancies to senior finance staff.
Continuous Improvement & Collaboration
Utilize SQL or other data query applications to prepare journal entries, accruals, and adjustments as required
Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Requirements

Undergraduate bachelor’s degree, with a record of strong academic performance in Accounting, Finance, Actuarial Science, Statistics, Economics, or Business Administration
4-6 year(s) of proven experience in financial/data analysis, actuarial services, accounting, pricing, or underwriting
Experience working with large data sets, containing both structured and unstructured data
Knowledge in SQL, Excel, and other data visualization tools (Python experience a plus though not required)
Ability to balance multiple complex projects simultaneously
Strong understanding of pharmacy pricing
Exceptional written and verbal communication skills
Extremely flexible, highly organized, and able to shift priorities easily.

Benefits

Health insurance
Professional development opportunities
Flexible work arrangements

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

financial analysisdata analysisbilling processesinvoicingreconciliationSQLdata visualizationExceljournal entriesaccruals

Soft Skills

communicationorganizational skillsflexibilityproject managementcollaborationanalytical skillsattention to detailproblem-solvingtime managementadaptability