Pharmacy Recovery Analyst

Rawlings Company; United States; Hybrid; USD 58,000 - 70,000; Full time

Benefits offered by this job

PTO, Holidays, Volunteer Days

Health, vision and dental coverage

401(k) with company match

Tuition reimbursement

Life insurance, disability, parental

Remote and hybrid work options

Job summary

Machinify, a leading healthcare intelligence company, seeks a professional to manage the pharmacy claim recovery process for clients. You will collaborate with payers to enhance reconciliation, analyze outcomes for process improvements, and generate team reporting.

Ideal candidates have strong analytical skills, SQL knowledge, and experience with MS Excel; a degree or 2–3 years of relevant work is required. Remote/hybrid options available.

Qualifications

• Bachelor's degree or 2-3 years directly applicable experience.
• Excellent work ethic.
• Strong analytical skills with experience organizing and summarizing data and preparing analysis and recommendations.
• Critical thinking, creativity and problem-solving skills; ability to propose viable solutions.
• Must work well on a team and individually with the ability to plan and schedule activities to accomplish objectives in a dynamic environment.
• Experience with MS Office Suite, specifically Pivot Tables and V-Lookup.
• Ability to write, edit and understand SQL Select Queries.
• Experience with lean and Six Sigma process development concepts preferred.
• Experience in the pharmacy benefit management, health insurance, and/or accounts receivable management industries preferred.

Responsibilities

• Collaborate with payers to establish and enhance reconciliation processes.
• Think critically and analyze outcomes to support development of process improvements.
• Develop and generate team reporting.
• Develop and maintain process documentation.

Skills

Analytical skills

SQL queries

Excel (Pivot Tables, VLOOKUP)

Teamwork

Problem solving

Education

Bachelor's degree or 2-3 years relevant experience

Tools

Pivot Tables

V-LOOKUP

Excel

Job description

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We're constantly reimagining what's possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

About the Opportunity

At Machinify, we're constantly reimagining what's possible in our industry-creating disruptively simple, powerfully clear ways to maximize our clients' financial outcomes today and drive down healthcare costs tomorrow. As part of the Pharmacy Payer-to-Payer team, you will manage the pharmacy claim recovery process on behalf of Machinify clients.

What you'll do

• Collaborate with payers to establish and enhance reconciliation processes.


• Think critically and analyze outcomes to support the development of process improvements that increase the effectiveness of recovery efforts.


• Develop and generate team reporting.


• Develop and maintain process documentation.

What experience you bring (Role Requirements)

• Bachelor's degree or 2 - 3 years of directly applicable experience


• Excellent work ethic


• Strong analytical skills with experience organizing and summarizing data and preparing analysis and recommendations.


• Critical thinking, creativity and problem-solving skills; ability to propose viable solutions


• Must work well on a team and individually with the ability to plan and schedule activities to accomplish objectives in a dynamic environment


• Experience with MS Office Suit, specifically the use of Pivot Tables and V-Lookup


• Ability to write, edit and understand SQL Select Queries.


• Experience with lean and Six Sigma process development concepts preferred


• Experience in the pharmacy benefit management, health insurance, and/or accounts receivable management industries preferred

What Success Looks Like...

After 3 months

You will have a strong understanding of the role.

You begin building relationships and collaborating with peers.

You develop effective time and priorities management.

You receive initial feedback about your performance and are using it to improve.

You've gained confidence in your abilities and are starting to feel more comfortable in your role.

After 1 year

You have mastered the tasks and responsibilities of the position, executing them with confidence and efficiency.

You have established a strong network of internal relationships and are recognized as a key collaborator.

You've been entrusted with greater responsibility indicating the company's confidence in your abilities.

You see opportunities for career progression and personal development.

Pay range: $64,000 annual salary with significant bonus opportunity. This is an exempt position.

What's in it for you

• PTO, Paid Holidays, and Volunteer Days


• Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts


• Tuition Reimbursement


• Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.


• Remote and hybrid work options

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/