Note: The job is a remote job and is open to candidates in USA. CVS Health is a healthcare company focused on creating a more connected, convenient, and compassionate health experience. The Member Payments Analyst supports accurate and timely member payment processing across PBM Financial Operations by researching, reconciling, documenting, and resolving payment-related issues. The role also develops operational reports, collaborates with cross-functional teams, and supports system enhancements and process improvements.
Responsibilities
- The Member Payments Analyst supports the accurate and timely processing of member payment activity across PBM Financial Operations
- This role is responsible for researching, reconciling, documenting, and resolving payment-related work tied to member reimbursements, recoupments, check voids, reissues, daily balancing, SalesForce cases, and Compass tasks
- The analyst works closely with internal partners to ensure payments are handled accurately, audit trails are complete, service expectations are met, and member/client impacts are understood
- In addition, this role partners closely with the Member Impact System (MIS) team to support system enhancements, issue identification and resolution, testing activities, reporting needs, and process improvements that improve the member payment experience
- The analyst is responsible for developing, maintaining, and analyzing operational reports that provide visibility into payment activity, trends, reconciliation results, and business performance metrics
- This position also collaborates across multiple departments, including Operations, Technology, Finance, Member Services, and Product teams, to support cross-functional initiatives, resolve complex issues, and drive continuous improvement efforts
- This role requires strong attention to detail, sound judgment, clear communication, and the ability to work through complex payment research from start to finish
- The analyst will manage multiple priorities in a fast-paced, process-driven environment while following established procedures, documenting work clearly, escalating issues appropriately, and supporting ongoing process improvement across the Member Payments team
- The analyst must also be comfortable interpreting and presenting data, creating meaningful reports and insights, partnering with the MIS team on system-related initiatives, and collaborating with cross-functional stakeholders to identify root causes, recommend solutions, and support operational excellence
Skills
- 2 or more years of experience in a finance or accounting operations role
- Excel skills include ability to manage and present large volumes of data, creating/using complex formulas, report formatting, pivot tables, data manipulation, and other advanced functions
- Working knowledge of SAP or similar financial systems; experience with transaction research, payment application, check review, voids, reissues, or account reconciliation
- Experience with Salesforce, Compass, or other case/task management tools
- High School Diploma or GED
- Experience in healthcare, PBM, finance operations, member reimbursement, claims, or payment processing, accounting
- Experience with RxClaim and other CVS Caremark specific applications
- Ability to research issues, identify trends or discrepancies, and determine appropriate next steps
- Understanding of audit controls, documentation standards, SOX, HIPAA, PII/PHI, and financial operations compliance expectations
- Strong written and verbal communication skills, including the ability to document actions clearly and explain findings to internal partners
- Ability to manage multiple tasks, meet service-level expectations, and escalate issues when additional support or approval is needed
- Customer-service mindset with the ability to balance timely case resolution, accuracy, and member/client impact
- Process improvement, cross-training, and documentation
- Experience partnering with technology teams, including the Member Impact System (MIS) team, to support system enhancements, testing, issue resolution, and process optimization
- Demonstrated experience creating, maintaining, and analyzing operational or financial reports, including identifying trends, risks, and opportunities through data analysis
- Strong cross-functional collaboration skills with the ability to work effectively across Operations, Technology, Finance, Product, and Customer Service teams to achieve shared business objectives
- Experience supporting business initiatives, process improvement projects, and user acceptance testing (UAT) activities for system changes and enhancements
Benefits
- Eligibility for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
- Medical, dental, and vision coverage, based on eligibility.
- Paid time off, based on eligibility.
- Retirement savings options, based on eligibility.
- Wellness programs, based on eligibility.
- Other resources designed to support the physical, emotional, and financial well-being of colleagues and their families, based on eligibility.
Company Overview