• Efficiently oversee CLD Claims for over 12 internal clients, ensuring files are downloaded through automation, verifying successful uploads, and promptly communicating the status of each request.

• Thoroughly examine diverse Excel and text files to address any error handling requirements in CLD uploads.
• Possess a proficient understanding of multiple portals, adeptly navigating their functionalities, and assisting colleagues in retrieving essential data.
• Effectively communicate any concerns within the business process, ensuring seamless execution from initiation to completion.
• Collaborate with cross-functional teams to streamline CLD claims processes and implement improvements for enhanced efficiency.
• Stay updated on best practices related to CLD claims management, actively seeking opportunities to enhance internal processes.
• Contribute to a positive work environment, fostering teamwork, and actively participating in team meetings and initiatives.

Job Profile

• Resolve the errors based on defined set of rules and perform correction where required.
• Meeting contractual deadlines. Managing workload to accommodate more challenging timelines.
• Ensuring customer compliance with contract terms. Working with unconventional customer data formats.
• Monitors and reviews data from the system.
• Reconcile, track, and troubleshoot requested vs actual data received/validated.
• Analyze errors and troubleshoot solutions.

• Any bachelors level degree accepted (finance, accounting, or information management preferred)
• 3+ total years of experience in a professional work environment, including 1+ years of relevant experience
• MS-Office working knowledge, especially strong capability in using Excel, is a must
• Experience in claims processing or handling claims utilization data is preferred.
• Prior work experience preferred in Insurance, Finance, and Pharma contracting domains as a Data Analyst/Claims Analyst/Rebate Analyst/Process Associate.
• Familiarity with data scrubbing, NCPDP data formats and Microsoft Access software is a plus
• Previous working knowledge of claims processing, financial report handling/generation is preferred
• Prior experience in end to end data processing in ERP and financial systems is preferred
• Ability to analyze large volumes of data for relevant trends.
• Candidates with working knowledge on Managed Care, Medicaid, Contracting, and Government Pricing applications shall be prioritized