Department

Job Title

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Finance

Associate, Pharmacy Financial Operations

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

About Capital Rx:

Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

Position Description:

The Associate, Finance Operations position is a hands-on position responsible for managing the day-to-day operations and activities of the finance team. The Associate, Pharmacy Financial Operations should be highly motivated, have a positive team attitude, and support the overall organization.

Position Responsibilities:

\n
• Review, analyze, and reconcile pharmacy claims and payments data.
\n
• Configure vendors for payment processing in our financial system.
\n
• Verify and ensure that all vendors possess all required credentials.
\n
• Ensure accurate and timely processing of pharmacy, member, and provider payments and remittances.
\n
• Collaborate with pharmacy network partners to resolve payment-related inquiries.\n
  \n
  • Investigate and resolve payment discrepancies and variances.
  \n
  • Develop and maintain strong relationships with pharmacies, providers, and reconciliation companies.
  \n
  \n
\n
• Prepare and distribute paper or electronic (835) remittances and reports.
\n
• Manage the reissuance of checks for voided or reprocessed payments.
\n
• Monitor and report on key performance indicators related to payment accuracy and timeliness.
\n
• Ensure compliance with state regulations by submitting unclaimed funds to the state.
\n
• Participate in the development and implementation of financial policies and procedures.
\n
• Assist in financial audits and provide documentation as needed.
\n
• Stay up to date with industry standards and compliance requirements.
\n
• Other responsibilities as assigned.
\n

Required Qualifications:

\n
• Bachelors degree in Accounting, Finance or Business or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
\n
• 2+ years of experience in PBM with a focus on claims, payments, and remittances.
\n
• Strong analytical and problem-solving skills.
\n
• Proficiency in Microsoft Excel and financial software.
\n
• Excellent communication and interpersonal skills.
\n
• Detail oriented with a high level of accuracy.
\n
• Ability to work collaboratively in a team and independently.
\n
• Knowledge of healthcare compliance regulations is a plus.
\n

Base Salary: $65,000 - $70,000

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.