Senior Data Reconciliation Specialist - Remote Opportunity

Remote Full-time
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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