Financial Operations Analyst
What you’ll do
In a few words…
Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…
Safeguarding the financial health of Abarca is of the upmost importance! Our Finance team ensures that our financial systems are running smoothly and efficiently. Within Financial Operations, the team juggles everything from financial reporting, compliance, risk management, client billing and payments, maintaining procedures to bookkeeping, cashflow management and maintaining good financial planning.
As Financial Operations Associate Analyst you will be responsible for client billing, provider and members payment process, payments void and reissue request and provide support with pharmacy price appeals. Also, will support initiatives and financial reporting as needed and will perform other tasks related to Abarca Health’s clients’ financial performance.
The fundamentals for the job…
- 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 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.
What we expect of you
The bold requirements…
- Bachelor’s or Master’s Degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
- 3+ years of experience in an analytical, finance, accounting, or auditing role.
- Experience working with financial reports and analysis utilizing dashboard tools - Tableau, QVW and Excel 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).
Nice to haves…
- Experience in healthcare or PBM is a plus.
- Experience or knowledge working with SQL.
Physical requirements…
- Must be able to access and navigate each department at the organization’s facilities.
- Sedentary work that primarily involves sitting/standing.
At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Applicant must be a United States’ citizen. Abarca Health LLC does not sponsor employment visas at this time”
The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.