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RxCompass Claims Operations Analyst

Eac49f24 652e 43a1 B2e9 5c0a30cfdc4a 19000101 000001 · Dallas, TX, US, Dallas, TX · Remote · Deleted · ADP Workforce Now Recruiting

Job facts

FieldValue
CompanyEac49f24 652e 43a1 B2e9 5c0a30cfdc4a 19000101 000001
TitleRxCompass Claims Operations Analyst
Normalized title-
Department / team-
LocationDallas, TX, United States
Work modelRemote / Remote
Employment type-
Salary-
Statusdeleted
ATS providerADP Workforce Now Recruiting
Posted / first seen2026-05-29 / 2026-05-31
Changed / last seen2026-06-06 / 2026-06-04

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Linked records

CompanyEac49f24 652e 43a1 B2e9 5c0a30cfdc4a 19000101 000001
Sourcea01cb435-efe0-4fd7-a8ee-474489a65e87
ATS providerADP Workforce Now Recruiting

Description

RxCompass Claims Operations Analyst Position Overview The Claims Operations Analyst is responsible for supporting claims processing, loading, quality review, reconciliation, aging visibility, and issue resolution across RxCompass and Variable Copay vendor programs. This role will process and review incoming vendor claims submissions, validate file accuracy, identify discrepancies, support claims dispute resolution, and maintain clear visibility into claim status throughout the full claims lifecycle. Reporting to the Supervisor, Data & Analytics, RxCompass/VCP , this position will work closely with Data & Analytics, Finance, Business Integration, Vendor Management, Operations, and external vendors to ensure claims are processed accurately, timely, and in accordance with defined workflow expectations. The Claims Operations Analyst plays a key role in preventing claims backlogs, supporting accurate client billing and vendor payment, maintaining claims lifecycle visibility, and escalating risks before they create financial, operational, or member service impact. Role and Responsibilities Claims Processing & Quality Review Process, load, and quality review incoming vendor claims submissions across multiple vendors, ensuring accuracy and adherence to strict processing timelines. Receive, review, and track vendor claims files submitted through SFTP, FTP, email, or other approved channels. Validate vendor claims submissions for completeness, formatting, accuracy, eligibility, and processing readiness. Manipulate and manage various Excel file formats as part of daily claims processing, reconciliation, and reporting workflows. Execute limited SQL queries and Snowflake worksheets in support of claims processing, validation, reconciliation, and reporting needs. Claims Reconciliation & Issue Resolution Reconcile vendor claim files against internal processing records, payment files, remittance reports, and outstanding vendor balances. Identify, document, and communicate claims errors, file issues, rejections, and discrepancies to vendors and internal teams in a timely manner. Track rejected, incomplete, or pending claims and coordinate follow-up through resolution. Assist with claims disputes and reconciliations in collaboration with cross-functional teams. Support vendor balance reviews and help identify differences between vendor-reported balances and internal claims/payment status. Submit and track internal tickets to the appropriate departments for resolution and escalation as needed. Claims Aging, Reporting & Escalation Track claims received, claims processed, claims rejected, claims pending, and claims resolved. Maintain claims aging visibility and escalate delayed, unresolved, or high-risk items according to defined thresholds. Prepare routine claims status updates, aging summaries, backlog reports, and open-item trackers for leadership review. Support visibility into oldest outstanding claim dates, pending dollar exposure, processing volume, and claims requiring cross-functional action. Communicate claims status, risks, blockers, and support needs clearly to the Supervisor, Data & Analytics and other internal stakeholders. Vendor & Cross-Functional Collaboration Maintain consistent communication with vendors and stakeholders throughout the claims lifecycle. Partner with Finance to support visibility into claims ready for client billing and vendor payment. Partner with Business Integration, Vendor Management, Data & Analytics, and Operations to resolve claims-related blockers and vendor workflow issues. Support Site of Care vendor management workflows as needed, including review of claims involving J-Codes and/or procedure codes. Process Improvement & Documentation Support the development and maintenance of standard operating procedures, trackers, and reporting tools related to vendor claims processing and reconciliation. Identify opportunities to improve automation, reporting accuracy, workflow efficiency, and backlog prevention. Support testing or validation of system changes related to vendor claims processing. Compliance & Confidentiality Maintain confidentiality of sensitive medical information and comply with HIPAA Privacy and Security Rules. Abide by all obligations under HIPAA related to Protected Health Information. Report any suspected HIPAA violations to the Compliance Officer and/or Human Resources. Attend and complete all required HIPAA training. Job responsibilities may evolve as business needs change. Supervisory Responsibility None. Required Skills and Competencies Strong attention to detail and ability to identify discrepancies across claims files, reports, balances, and payment data. Strong Excel skills, including ability to work with multiple file formats, filters, formulas, pivot tables, lookups, and reconciliation workbooks. Ability to execute limited SQL queries and Snowflake worksheets with direction. Ability to review claims files for accuracy, completeness, and formatting issues. Strong organizational, follow-up, and time management skills. Ability to manage recurring deadlines and multiple vendor workstreams. Strong written and verbal communication skills. Ability to communicate claims errors, discrepancies, blockers, and risks clearly to vendors and internal stakeholders. Ability to escalate risks timely and appropriately. Familiarity with claims files, remittance files, vendor reporting, or payment reconciliation. Ability to work with SFTP/FTP file exchange processes. Problem solving and root-cause analysis. Ability to work independently with limited direction. Ability to communicate technical or claims-related issues to non-technical stakeholders. Thoroughness, accuracy, accountability, and sound judgment. Microsoft Office Suite proficiency. Preferred Skills and Experience Experience with pharmacy claims, PBM operations, specialty pharmacy, copay assistance, Site of Care, or healthcare vendor operations. Familiarity with pharmacy claims terminology, NDCs, eligibility logic, rejection logic, J-Codes, procedure codes, remittance reporting, and vendor claim submissions. Experience with SQL, Snowflake, SSRS, Power BI, or other reporting tools. Experience maintaining claims aging, vendor reconciliation, backlog, or open-item trackers. Experience supporting cross-functional workflows involving Finance, Operations, Data, Business Integration, and external vendors. Experience submitting and tracking internal tickets through resolution. Experience working in a HIPAA-regulated environment. Position Type and Expected Hours of Work Full-time/Salaried/Exempt. Some flexibility in hours is allowed, but the employee must be available during the “core” work hours of 8:00 AM to 5:00 PM CT. We cover clients from the West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays pursuant to industry demands. Travel No travel is expected for this position. What We Have to Offer Our Benefits package is designed to keep our employees happy and healthy - physically, mentally and financially. Medical, Dental, and Vision insurance Disability and Life insurance Employee Assistance Program Remote work options Generous Paid-Time Off Annual Reviews and Development Plans Retirement Plan with company Match immediately 100% vested Required Education and Experience High school diploma or equivalent required. Associate’s degree preferred 1–3 years of equivalent experience in PBM, healthcare claims, claims adjudication, claims reconciliation, vendor operations, or related healthcare operations required. Preferred Education and Experience Associate’s or Bachelor’s degree in Business, Healthcare Administration, Information Systems, Data Analytics, Finance, or a related field preferred. Experience in pharmacy claims, healthcare data, vendor reconciliation, billing support, finance operations, or data/reporting operations preferred. Intermediate Excel experience strongly preferred. SQL, Snowflake, SSRS, or Power BI experience preferred but not required. Pharmacy benefit management, specialty pharmacy, Site of Care, or healthcare vendor operations experience preferred. RxCompass, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, RxCompass, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. RxCompass, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of RxCompass, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V

Full job record

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TitleRxCompass Claims Operations Analyst
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First Seen At2026-05-31 18:46:02Z
Last Seen At2026-06-04 08:28:35Z
Last Checked At2026-06-06 12:17:55Z
Last Changed At2026-06-06 12:17:55Z
Inactive At2026-06-06 12:17:55Z
Source Posted At2026-05-29 16:19:00Z
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    "requisitionDescription": "<div><p><strong><span style=\"font-size: 24px;\">RxCompass Claims Operations Analyst</span></strong></p><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;font-weight:bold;' data-pasted=\"true\"><span style=\"font-family: Calibri; font-size: 18px;\">Position Overview</span></h1><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'><span style=\"font-size: 18px; font-family: Calibri, sans-serif;\">The Claims Operations Analyst is responsible for supporting claims processing, loading, quality review, reconciliation, aging visibility, and issue resolution across RxCompass and Variable Copay vendor programs. This role will process and review incoming vendor claims submissions, validate file accuracy, identify discrepancies, support claims dispute resolution, and maintain clear visibility into claim status throughout the full claims lifecycle.</span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'><span style=\"font-size: 18px; font-family: Calibri, sans-serif;\">Reporting to the <strong><span style='font-family:\"Calibri\",sans-serif;font-weight:normal;'>Supervisor, Data &amp; Analytics, RxCompass/VCP</span></strong>, this position will work closely with Data &amp; Analytics, Finance, Business Integration, Vendor Management, Operations, and external vendors to ensure claims are processed accurately, timely, and in accordance with defined workflow expectations.</span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;'><span style=\"font-size: 18px; font-family: Calibri, sans-serif;\">The Claims Operations Analyst plays a key role in preventing claims backlogs, supporting accurate client billing and vendor payment, maintaining claims lifecycle visibility, and escalating risks before they create financial, operational, or member service impact.</span></p><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;font-weight:bold;'><span style=\"font-size: 18px;\"><br></span></h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;font-weight:bold;'><span style=\"font-family: Calibri; font-size: 18px;\">Role and Responsibilities<br>&nbsp;</span><span style=\"font-family: Calibri; font-weight: normal; font-size: 18px;\"><br>&nbsp;</span><span style=\"font-size: 18px; font-family: Calibri;\">Claims Processing &amp; Quality Review</span></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Process, load, and quality review incoming vendor claims submissions across multiple vendors, ensuring accuracy and adherence to strict processing timelines.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Receive, review, and track vendor claims files submitted through SFTP, FTP, email, or other approved channels.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Validate vendor claims submissions for completeness, formatting, accuracy, eligibility, and processing readiness.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Manipulate and manage various Excel file formats as part of daily claims processing, reconciliation, and reporting workflows.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Execute limited SQL queries and Snowflake worksheets in support of claims processing, validation, reconciliation, and reporting needs.&nbsp;</span></li></ul></div><p style='margin-right:0in;margin-left:.25in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;text-indent:-.25in;'><span style=\"font-size: 18px;\"><strong>&nbsp;</strong></span></p><p style='margin-right:0in;margin-left:.25in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:1.5pt;margin-bottom:1.5pt;text-indent:-.25in;'><span style=\"font-size: 18px;\"><strong><span style=\"font-family:Calibri;\">Claims Reconciliation &amp; Issue Resolution</span></strong></span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Reconcile vendor claim files against internal processing records, payment files, remittance reports, and outstanding vendor balances.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Identify, document, and communicate claims errors, file issues, rejections, and discrepancies to vendors and internal teams in a timely manner.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Track rejected, incomplete, or pending claims and coordinate follow-up through resolution.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Assist with claims disputes and reconciliations in collaboration with cross-functional teams.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Support vendor balance reviews and help identify differences between vendor-reported balances and internal claims/payment status.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Submit and track internal tickets to the appropriate departments for resolution and escalation as needed.&nbsp;</span></li></ul><p><span style=\"font-family: Calibri; font-size: 18px;\"><br></span></p></div><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:.25in;text-indent:-.25in;font-size:13px;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><span style=\"font-size: 18px;\"><strong><span style=\"font-family:Calibri;\">Claims Aging, Reporting &amp; Escalation</span></strong></span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Track claims received, claims processed, claims rejected, claims pending, and claims resolved.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Maintain claims aging visibility and escalate delayed, unresolved, or high-risk items according to defined thresholds.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Prepare routine claims status updates, aging summaries, backlog reports, and open-item trackers for leadership review.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Support visibility into oldest outstanding claim dates, pending dollar exposure, processing volume, and claims requiring cross-functional action.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Communicate claims status, risks, blockers, and support needs clearly to the Supervisor, Data &amp; Analytics and other internal stakeholders.&nbsp;<br>&nbsp;&nbsp;</span></li></ul></div><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:.25in;text-indent:-.25in;font-size:13px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><strong><span style=\"font-family:Calibri;\">Vendor &amp; Cross-Functional Collaboration</span></strong></span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Maintain consistent communication with vendors and stakeholders throughout the claims lifecycle.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Partner with Finance to support visibility into claims ready for client billing and vendor payment.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Partner with Business Integration, Vendor Management, Data &amp; Analytics, and Operations to resolve claims-related blockers and vendor workflow issues.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Support Site of Care vendor management workflows as needed, including review of claims involving J-Codes and/or procedure codes.&nbsp;<br>&nbsp;</span></li></ul></div><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:.25in;text-indent:-.25in;font-size:13px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><strong><span style=\"font-family:Calibri;\">Process Improvement &amp; Documentation</span></strong></span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Support the development and maintenance of standard operating procedures, trackers, and reporting tools related to vendor claims processing and reconciliation.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Identify opportunities to improve automation, reporting accuracy, workflow efficiency, and backlog prevention.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Support testing or validation of system changes related to vendor claims processing. &nbsp;<br>&nbsp;</span></li></ul></div><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:.25in;text-indent:-.25in;font-size:13px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><strong><span style=\"font-family:Calibri;\">Compliance &amp; Confidentiality</span></strong></span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Maintain confidentiality of sensitive medical information and comply with HIPAA Privacy and Security Rules.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Abide by all obligations under HIPAA related to Protected Health Information.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Report any suspected HIPAA violations to the Compliance Officer and/or Human Resources.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Attend and complete all required HIPAA training.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Job responsibilities may evolve as business needs change.</span></li></ul></div><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;text-indent:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><strong>&nbsp;</strong></span></p><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-family: Calibri; font-size: 18px;\">Supervisory Responsibility</span></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">None.</span></li></ul></div><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><br></span></h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\">Required Skills and Competencies</span></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Strong attention to detail and ability to identify discrepancies across claims files, reports, balances, and payment data.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Strong Excel skills, including ability to work with multiple file formats, filters, formulas, pivot tables, lookups, and reconciliation workbooks.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to execute limited SQL queries and Snowflake worksheets with direction.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to review claims files for accuracy, completeness, and formatting issues.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Strong organizational, follow-up, and time management skills.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to manage recurring deadlines and multiple vendor workstreams.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Strong written and verbal communication skills.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to communicate claims errors, discrepancies, blockers, and risks clearly to vendors and internal stakeholders.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to escalate risks timely and appropriately.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Familiarity with claims files, remittance files, vendor reporting, or payment reconciliation.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to work with SFTP/FTP file exchange processes.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Problem solving and root-cause analysis.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to work independently with limited direction.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Ability to communicate technical or claims-related issues to non-technical stakeholders.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Thoroughness, accuracy, accountability, and sound judgment.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Microsoft Office Suite proficiency.<br>&nbsp;<br></span></li></ul><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><span style=\"font-size: 18px;\">Preferred Skills and Experience</span></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: 0in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience with pharmacy claims, PBM operations, specialty pharmacy, copay assistance, Site of Care, or healthcare vendor operations.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Familiarity with pharmacy claims terminology, NDCs, eligibility logic, rejection logic, J-Codes, procedure codes, remittance reporting, and vendor claim submissions.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience with SQL, Snowflake, SSRS, Power BI, or other reporting tools.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience maintaining claims aging, vendor reconciliation, backlog, or open-item trackers.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience supporting cross-functional workflows involving Finance, Operations, Data, Business Integration, and external vendors.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience submitting and tracking internal tickets through resolution.&nbsp;</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri;\">Experience working in a HIPAA-regulated environment.</span></li></ul></div><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><br>&nbsp;Position Type and Expected Hours of Work</span></h1><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: -0.25in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Full-time/Salaried/Exempt.</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Some flexibility in hours is allowed, but the employee must be available during the &ldquo;core&rdquo; work hours of 8:00 AM to 5:00 PM CT. We cover clients from the West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays pursuant to industry demands.</span></li></ul></div><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\">Travel</span></h1><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\">No travel is expected for this position.</span></p><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><span style=\"font-size: 18px;\">&nbsp;</span></h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\">What We Have to Offer</span></h1><p><span style=\"font-size: 18px;\">Our Benefits package is designed to keep our employees happy and healthy - physically, mentally and financially.&nbsp;</span></p><div style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><ul style=\"margin-bottom:0in;list-style-type: disc;margin-left: -0.25in;\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Medical, Dental, and Vision insurance</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Disability and Life insurance</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Employee Assistance Program</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Remote work options</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Generous Paid-Time Off</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Annual Reviews and Development Plans</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri; color: black;\">Retirement Plan with company Match immediately 100% vested</span></li></ul></div><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><br></span></h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\">Required Education and Experience</span></h1><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">High school diploma or equivalent required.</li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri, sans-serif;\">Associate&rsquo;s degree preferred</span></li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\"><span style=\"font-family: Calibri, sans-serif;\"><span style=\"font-family: Calibri, sans-serif;\" data-pasted=\"true\">1&ndash;3 years of equivalent experience in PBM, healthcare claims, claims adjudication, claims reconciliation, vendor operations, or related healthcare operations required.&nbsp;</span></span></li></ul><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;'><span style=\"font-size: 18px;\"><br></span></h1><h1 style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:15px;font-family:\"Calibri\",sans-serif;' data-pasted=\"true\"><span style=\"font-size: 18px;\">Preferred Education and Experience</span></h1><ul style=\"margin-bottom:0in;margin-top:0in;\" type=\"disc\"><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">Associate&rsquo;s or Bachelor&rsquo;s degree in Business, Healthcare Administration, Information Systems, Data Analytics, Finance, or a related field preferred.</li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">Experience in pharmacy claims, healthcare data, vendor reconciliation, billing support, finance operations, or data/reporting operations preferred.</li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">Intermediate Excel experience strongly preferred.</li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">SQL, Snowflake, SSRS, or Power BI experience preferred but not required.</li><li style=\"margin: 1.5pt 0in; font-size: 18px; font-family: initial;\">Pharmacy benefit management, specialty pharmacy, Site of Care, or healthcare vendor operations experience preferred.</li></ul><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><strong><span style=\"font-size: 18px;\">&nbsp;</span></strong></p><p style='margin-top:1.5pt;margin-right:0in;margin-bottom:1.5pt;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;'><br></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:0in;margin-bottom:7.5pt;line-height:13.5pt;' data-pasted=\"true\"><span style=\"font-size: 18px; font-family: Calibri, sans-serif;\">RxCompass, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, RxCompass, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.</span></p><p style='margin-right:0in;margin-left:0in;font-size:13px;font-family:\"Calibri\",sans-serif;margin-top:0in;margin-bottom:7.5pt;line-height:13.5pt;'><span style=\"font-size: 18px; font-family: Calibri, sans-serif;\">RxCompass, LLC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of RxCompass, LLC employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/D/V</span></p></div></div>\n",
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