Position Summary: CVS Health Specialty Pharmacy, a mail service pharmacy in the Monroeville area has an opportunity for a full-time Payment File Electronic Data Interchange (EDI) Specialist to handle payment file processing activities.
The Payment File EDI specialist's day-to-day responsibilities include establishing contact with trading partners, analyzing the data exchanged with any partners, observing data records to identify file errors, and correcting any failures.
The Payment File EDI specialty will communicate with employees at various levels of our organization to support accurate, proper data exchanges within the organization. The specialist must be able to communicate effectively internally and externally to resolve any file issues; establishing contact with trading partners and customers and communicating in a professional and friendly manner.
A technical understanding of 835 file formats, how to identify what information is presented in the file in a format that cannot be successfully processed by the specialty AR systems, and how to convert files to the expected 835 file format that can be accepted by the AR systems for payment application, . To be successful in this role, the colleague must have an understanding of how files are retrieved from the trading partner whether manual or via an automated job setup internally that pushes the file to our server.
This colleague is responsible for the 835 file process from beginning to end which includes retrieving the 835 file, fixing the file, and loading the file successfully into the accounts receivable system(s). Loading of fixed files and auto-posting of files will deliver positive outcomes by reducing the overall A/R to ensure the departmental goals.
Analyze current implementation to make recommendations for process improvements.
Work with various trading partners to resolve any operational issues
Coordinate and test new files from trading partners to add to the load process. Required Qualifications:2 or more years’ experience working with EDI tools such as FileZilla, IPswitch , and/or ClarEdi .
2 or more years’ experience in creating and editing Macros to correct EDI file errors.
Preferred Qualifications: 4+ years of industry experience working with EDI technologies
Proficient in Microsoft Excel and Word.
Programming experience and concepts are helpful.
Additional related education and experience preferred in healthcare claims processing.
Knowledge normally evidenced by secondary education in accounting or information systems.
Prior experience in editing and configuring FTP software for file retrieval for existing and new trading partners; including connection error resolution.
Ability to multi-task, manage simultaneous projects, and prioritize task in a fast paced environment while displaying strong attention to detail
Healthcare industry experience
Ability to meet deadlines
Excellent problem-solving skills
Education: High school diploma/GED required.
Technical certifications or Bachelor's Degree in computer sciences preferred.
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW
and EEO IS THE LAW SUPPLEMENT
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CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.
For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/