Senior Billing & Operations Analyst (Non-Core Programs)

Judi Health, LLC; Denver (CO); Hybrid; USD 76,000 - 115,000; Full time

Job summary

Judi Health seeks a Senior Analyst to lead client financial operations focused on invoicing outside core PBM/PBA services, especially EGWP. You will design and optimize billing processes, interpret complex contracts, and drive automation to improve accuracy and governance.

You will partner with Technology and Finance to ensure invoices are accurate, timely, and compliant across multiple programs and locations, leveraging Excel and SQL skills to deliver scalable solutions.

Qualifications

• Undergraduate bachelor’s degree in Business, Finance, or quantitative field
• 5+ years of related experience in finance, data analysis, or accounting
• Experience specific to EGWP Premium invoicing
• Strong Excel and SQL Skills
• Ability to challenge and improve existing processes through automation and redesign
• Motivated team player with the ability to work in a fast-paced environment
• Attention to detail & commitment to high quality work
• Passion for healthcare and driving lasting change in pharmacy benefits
• Ability to define problems, collect data, establish facts, solve problems, make recommendations, and draw valid conclusions in a timely and accurate manner
• PBM experience preferred

Responsibilities

• Own and oversee billing operations for non-core programs, including EGWP, by interpreting complex, multi-year contracts, client program requirements, service volumes, fee structures, and financial data to determine appropriate billing approaches.
• Independently evaluate incomplete, conflicting, or unusual billing information; compare alternative courses of action; resolve material issues within established authority; and elevate matters requiring broader approval with a recommended solution.
• Interpret contract terms, and client-specific arrangements to identify billable items, establish appropriate billing mechanisms, and advise internal partners on financial and operational implications.
• Design, implement, and refine invoicing processes, controls, schedules, and operating practices for new and existing programs, coordinate with technology teams when standard procedures do not cover contractual requirements.
• Analyze data from financial, adjudication, membership, and other operational systems to assess billing accuracy, identify trends and financial exposure, determine root causes, and recommend corrective or preventive action.
• Direct invoice preparation, reconciliation, and issuance in accordance with contractual requirements.
• Lead reconciliations across ERP, adjudication, and related platforms; assess the significance of variances; determine appropriate resolution; and coordinate implementation with Finance, Client Services, Operations, and other stakeholders.
• Evaluate existing processes and controls, prioritize improvement opportunities, and use Excel, SQL, or other analytical tools to develop automation and redesign solutions that improve accuracy, scalability, and financial governance.
• Develop and maintain billing policies, procedures, decision criteria, and supporting documentation; recommend changes to operating practices and help implement approved improvements across affected business areas.
• Lead audit and compliance support for assigned programs.

Skills

Excel

SQL

Finance

Data analysis

Healthcare invoicing

EGWP invoicing

Automation

Education

Bachelor's degree in Business/Finance

Tools

ERP systems

Billing software

Job description

Judi Health seeks a Senior Analyst to lead client financial operations focused on invoicing outside core PBM/PBA services, especially EGWP. You will design and optimize billing processes, interpret complex contracts, and drive automation to improve accuracy and governance.

You will partner with Technology and Finance to ensure invoices are accurate, timely, and compliant across multiple programs and locations, leveraging Excel and SQL skills to deliver scalable solutions.