Join our team of dedicated professionals at CVS Health, where we're committed to delivering exceptional healthcare solutions with heart. We're seeking a highly skilled and results-driven Senior Data Reconciliation Specialist to join our Medicare Prescription Payment Plan (M3P) team. As a Senior Data Reconciliation Specialist, you will play a critical role in ensuring the timely and accurate loading of members' data, enabling them to utilize the Medicare Prescription Payment Plan within the CMS mandated turnaround time.
In this dynamic and challenging role, you will have the opportunity to demonstrate your expertise in data reconciliation, IT ticket management, and stakeholder communication. You will be responsible for monitoring transmission and receipt of clients' M3P opt-in/opt-out files, creating and escalating IT tickets, and coordinating with internal and external stakeholders to resolve file issues. Your exceptional analytical, problem-solving, and communication skills will enable you to confidently speak across stakeholders, lead dispute resolution, and identify opportunities for process improvements.
Key Responsibilities:
- Monitor and remediate client M3P opt-in/opt-out files to ensure timely and accurate loading of members' data
- Create, monitor, and escalate IT tickets to resolve M3P opt-in/opt-out file issues
- Coordinate with internal and external stakeholders for M3P opt-in/opt-out file issue resolution
- Work independently and collaboratively as part of a cross-functional team to drive best practices and process improvements
- Lead dispute resolution and provide judgment and decisions for opt-in/opt-out member adjustments using industry-standard evidence and tools
- Identify and recommend opportunities for process improvements to meet or exceed productivity and quality goals
Requirements:
- 4+ years of professional experience working with business processes, data, IT ticketing, and communication skills
- Computer proficiency, including experience with Microsoft Office and industry-standard coding applications
- Experience with submitting, tracking, and resolving IT tickets
- Bachelor's Degree or equivalent work experience
Preferred Qualifications:
- Excellent analytical and problem-solving skills
- Superior communication, organizational, and interpersonal skills
- Experience with secure File Transfer Protocols (sFTP) file exchanges
- Experience with Splunk application, including building dashboards, reports, and queries
- RxClaim (AS400) experience
What We Offer:
- Competitive salary range: $18.50 - $31.72 per hour
- Eligibility for CVS Health bonus, commission, or short-term incentive program
- Comprehensive benefits package, including medical, dental, and vision benefits
- 401(k) retirement savings plan and Employee Stock Purchase Plan
- Paid Time Off (PTO) or vacation pay, paid holidays, and sick time
- Opportunities for professional growth and development
How to Apply: If you're a motivated and detail-oriented professional looking to join a dynamic team, please submit your application today. We can't wait to hear from you!
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