Inmar
Representative, PFM Business Intelligence
Headquarters, Winston Salem, NC
No sponsorshipDetected 30 days ago
Data AnalysisData VisualizationComplianceFinancial AnalysisAccountingAuditingHRISContract ManagementCustomer SupportHIPAACommunicationCollaborationProblem SolvingCritical ThinkingAdaptabilityMicrosoft Office
About the role
- Under the direction of a Supervisor, the Representative in PFM Business Intelligence is a member of the Business Intelligence team and is responsible for auditing contract and MAC exceptions and supporting client initiatives.
Responsibilities
- Builds relationships and works cooperatively with others, inside and outside the organization, to accomplish objectives to build and maintain mutually beneficial partnerships, leverage information and achieve results.
- Support a safe work environment by following safety rules and regulations and reporting all safety hazards.
- Create and deliver standard MAC reporting on a weekly basis to the client
- Identify, develop and implement new procedures to increase efficiency and productivity of work processes
- Design internal and external facing dashboards for trending and benchmarking
- Support the Product teams in relation to product enhancements:
- Continue to update MAC Appeals forms, spreadsheets, procedures, etc in the MAC Google Drive site
- Perform special projects and other duties as assigned by management
Requirements
- At least 2 years of relevant experience involving customer service, computer usage, data entry and data analysis AND an Associate's degree in Business Administration, Accounting, or a related field
- OR an equivalent combination of training and experience required to complete the essential functions/job responsibilities of the position
- Analytical and Critical Thinking: Ability to tackle a problem by using a logical, systematic, sequential approach.
- The physical demands described here are representative of those that must be met by an associate to successfully perform the major job responsibilities (essential functions) of this job.
- Regularly required to use hands to finger, handle or feel objects, tools or controls, and reach with hands or arms.
- Regularly required to talk or hear and read instructions on a computer monitor and/or printed on paper.
- Occasionally required to stand, kneel or stoop, and lift and/or move up to ## pounds.
- Regularly required to view items at an extremely close range and must be able to adjust and readjust focus.
- you also have the ability to perceive the needs of internal and external clients and communicate effectively with the objective of delighting and retaining the client.
Skills
- Understand the nature of retail pharmacy
- Monitor the data to ensure that the carriers adjusted reimbursement
- Use data visualizations appropriately and effectively
- Produce reports and other requested deliverables including financial analysis
- Contact clients for invoices when needed; fax invoices and supporting documentation to the carriers
- Upload claims in the Audit Management App
- Tag claims for Audits in the Pharmacy Management tool
- Pursue MAC appeals and Contract exceptions using the Contract Management App and Business Intelligence tools
- Follow documented best practices for submitting MAC and Contract exceptions to the carriers
Benefits
- Maintain HIPAA (Health Insurance Portability and Accountability Act) compliance in all client communication
- Medical, Dental, and Vision insurance
Equal opportunity
- We are an Equal Opportunity Employer, including disability/vets.
Visa & Work Authorization
- This position is not eligible for student visa sponsorship, including F-1 OPT or CPT.
This listing is sourced directly from Inmar's careers page and normalized into a canonical job model.