What you’ll do

In a few words…

Abarca is igniting a revolution in healthcare.  We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

As a Financial Operations Associate Analyst, you will be instrumental in supporting the client billing process, managing provider and member payments, pharmacy price appeals, and ensuring compliance with contractual obligations. Your role will extend to working on financial reports, supporting Medicare reporting requirements, and contributing to special projects aimed at improving Abarca Health’s financial performance. We are proud to foster an inclusive and innovative work environment where every team member can thrive. We offer flexible work models and encourage professional growth and development.

The fundamentals for the job…

• Execute client billing and provider payment processes, including related analysis, controls, and reconciliations.
• Manage invoice submissions to clients and payment issuances to providers, ensuring any concerns or discrepancies are addressed promptly to maintain client satisfaction.
• Oversee Direct Member Reimbursements (DMRs), adjustments, and approvals.
• Ensure compliance with timeliness requirements for pharmacy appeals.
• Support any client and/or pharmacy concerns and ensure resolution and satisfaction.
• Address and resolve client or pharmacy billing and payment inquiries efficiently.
• Identify opportunities for process improvement, risk mitigation, and cost-saving measures.
• Regularly review and analyze financial discrepancies and errors, offering recommendations for corrective actions.
• Contribute to the preparation and submission of Medicare reporting requirements and reconciliations.
• Provide support to the Medicare Reporting Requirements tasks and reconciliations, as well as other reporting requirements for other lines of business such as Commercial, Medicaid, among others.
• Support the Pharmacy Financial Services team in executing key tasks and handling special projects as needed.
• Collaborate cross-functionally with other departments to address financial reporting needs across business lines, including Commercial and Medicaid.

What we expect of you

The bold requirements… 

• Bachelor’s degree in accounting, Finance, or a related field (equivalent relevant work experience may be considered).
• 1+ years of experience in an analytical, finance, accounting, or auditing role.
• Proficiency in working with financial reports and data analysis tools such as Microsoft Excel, Tableau, or other reporting software.
• Strong attention to detail, with a proven ability to identify and resolve financial discrepancies.
• Exceptional communication skills, both oral and written.
• Fully bilingual in English and Spanish, with fluency in both languages.
• We are proud to offer a flexible hybrid work model, with on-site work required at our Puerto Rico location.
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to have… 

• Experience in healthcare or PBM is a plus.
• Experience or knowledge working with SQL.

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Primarily sedentary work, with frequent sitting or standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves.  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. 

Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify.  “Applicant must be a United States’ citizen or Permanent Resident. Abarca Health LLC does not sponsor employment visas at this time”

The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.