Prior Carrier Load Analyst

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
Facilitates the loading of Prior Carrier Plan accumulators or HRA contributions, via electronic data files or manual entry from prior plan Explanation of Benefits (EOBs), to assure members are given prior carrier credits, applicable HRA contributions and/or to allow for Stop Loss filings.Fundamental Components

• Monitors and manages internal installation process and maintains case tracking tools to meet clients expectations and business goals. (UAT and auditing are performed on each client load.)
• If required, communicates revisions essential for supporting and guarding the plan against unintended liability. Review data files within 24 hours to determine if the file is complete and contains the data elements required for loading.
• Consults and communicates with internal constituents regarding the details associated with new business and revision activity in a timely manner and validates account structure. Entry and follow through of the RTC ticket for IT assistance required to load the data files, including but not limited to:

• creating a thorough test plan and performing the User Acceptance Testing (UAT) associated with the ticket.
• Providing the applicable date ranges to be used
• Providing the applicable directive on type of claims to be loaded (medical, vision, Dental, Rx)
• Providing the applicable directive for inclusion or exclusion claims for stop loss filing

• 1 year healthcare industry experience with benefits interpretation.
• Proficient in Excel.

• Healthcare industry experience (Customer Service, Claims, and or Plan Build preferred)
• Dos System experience
• Good communication skills

• High school diploma or GED.

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.