Job details

PRCM Reporting Analyst (Remote)

Position Summary:

Under the direction of a Supervisor, the Reporting Analyst in Pharmacy Revenue Cycle Management (PRCM) works with internal business partners and clients to optimize third party reimbursement. The Reporting Analyst performs detailed analysis to identify revenue opportunities and is responsible for pursuing those opportunities by contacting Pharmacy Benefit Managers (PBM’s), industry payers and other third-party processors on behalf of clients in order to meet contractual agreements. Duties also include assisting with on-boarding of new clients, cross-training with other team members, developing and improving operating processes, monitoring system processes, recommending product enhancements and system testing.

Location: Winston Salem, NC is the preferred location. However, this position can site remote, but only for those based in the Eastern Time Zone.

Primary Accountabilities:

Analytical

Research and develop systems to optimize revenue through products and services such as maximum allowable cost (MAC) appeal submissions to third party payers
Perform trending analysis to ensure return on investment (ROI) metrics are met
Contact third party payers to facilitate action, developing follow-up strategy and documenting activity/results for clients when needed
Utilize PRCM business intelligence resources to conduct analysis, tracking results and pending efforts
Develop additional tracking methods to report analysis results in multiple formats and business case scenarios

Operational

Facilitate meetings with clients
Create dashboards with visualizations and data metrics that demonstrate Inmar’s value to customers
In conjunction with other internal business partners, develop client recommendations for business optimization based on data trends and results
Identify opportunities for improvement to client pharmacy operations Develop analytical methods to identify reimbursement opportunities and maximize business performance
Develop best practices/standard reporting for client and internal communication

Administrative

Identify system enhancements by working with IT/Product to define, implement and test enhancements
Meet client service level agreements related to PRCM key performance indicators
Manage day-to-day client relationships
Assist in the development and implementation of internal business optimization efforts such as automation initiatives and other process improvements
Assist account team with business review presentations
Maintain HIPAA (Health Insurance Portability and Accountability Act) compliance in all client communication
Inform team members and management on client cases, successes, and current inquiries
Cross train other associates to be backup when out of the office

Influence

Review exceptions management service by discussing Inmar and client’s responsibilities
Recommend guidelines and best practices for business rules
Establish industry contacts and communication methods
Perform special projects and other duties as assigned by management

Required Qualifications:

At least three years of relevant experience involving customer service, data entry and data analysis using business intelligence tools (e.g., Tableau, Power BI, Looker) and a Bachelors’ degree in Pharmacy, Business, Finance, or a related field: OR an equivalent combination of training and experience required to complete the essential functions/job responsibilities of the position
Intermediate-level proficiency using MS Excel and MS Word
Knowledge and experience with generating reports and client deliverables using data visualizations
Knowledge of servicing business accounts

Experience with the Retail Pharmacy industry is a plus.

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