Insurance AR Resolution Analyst, Revenue Cycle

Position Summary

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

About the role

CVS Health Third-Party Revenue Cycle Management (RCM), supporting CVS Retail pharmacies, has an opportunity for a full-time Insurance AR Resolution Analyst. As an RCM Analyst, you will perform advanced, payer-level analysis to support Third Party Account Management in maximizing collections, reducing bad debt, and ensuring compliance with federal, state, and CVS Health requirements.

Responsibilities

• Apply advanced analytical and statistical techniques to identify root causes of Third-Party payer issues
• Validate data accuracy and completeness using SQL and internal reporting tools
• Translate complex findings into clear, actionable recommendations for leadership
• Collaborate cross-functionally to prevent recurrence of payer issues
• Maintain regular and predictable attendance and perform additional duties within role scope

Requirements

• Knowledge of: Third Party Revenue Cycle operations, payer behavior, and liability resolution
• Commercial and Medicaid payer environments
• Skill In Advanced analytical and root cause diagnosis techniques
• Solid working knowledge of all MS Operating Systems and MS Office applications (MS Word, Excel, Access, PowerPoint), and process mapping software such as Microsoft Project and Visio
• SQL and data-mining tools to validate and reconcile financial data
• Familiarity with MicroStrategy, SQL, and other data mining tools
• Developing leadership-ready documentation and recommendations
• Ability To Independently evaluate complex problems and recommend effective solutions
• Influence decisions through data-driven insights rather than authority
• Prioritize and organize work to accurately complete projects or assignments on schedule
• Work individually or with a team to systematically identify and define problems, evaluate alternatives and implement practical, cost-effective solutions
• Frame recommendations and formally present them to management
• Work with sensitive financial and patient data in compliance with HIPAA
• Maintain composure and perform job duties/responsibilities when confronted with stressful situations
• Maintain excellent verbal and written communication skills and the ability to interact professionally with a diverse group - directors, managers, colleagues, and external entities
• Work in strict confidence, always ensuring the confidentiality of the patient and medical and financial records, in compliance with company and HIPAA Privacy guidelines
• Operate effectively in ambiguous or evolving environments

Qualifications

• Education Required: High School Diploma or General Equivalent Development (GED)
• Preferred: Bachelor Degree
• Prior Relevant Work Experience Preferred 3 to 5 years of analytics experience. 2+ years required.

Pay Range

The Typical Pay Range For This Role Is $43,888.00 - $102,081.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.