Finance

We are the financial foundation!

Our team maintains and supports fiscal responsibilities through accurate accounting and financial compliance. Our culture of continuous improvement enables the team to provide oversight, assistance, and training in financial stewardship for Abarca.

WHAT WE DO

Financial Operations

• Establish and regulate provider payments, including pharmacy payments, reconciliations, and related adjustments.
• Support and manage the provider payments process and the oversight of the Price Appeals, new client implementations, compliance, and audits.
• Ensure compliance with Center of Medicaid & Medicare Services Agency (CMS) financial requirements, including Direct/Indirect remuneration (DIR) submission, Direct Member reimbursement (DMR), and claims reprocessing and adjustments.

General Accounting

• Provide financial statements, manage cashflow reporting, cost accounting, and other reports, as needed, for internal and external audits on a monthly basis, in alignment with GAAP.
• Develop and maintain financial controls through expense accounting and review.
• Participate in the Annual Budget cycle, including quarterly forecasts and projections.

Rebates

• Lead all aspects of manufacturers’ rebate contract interpretations, formulary compliance, system capabilities, billing, reconciliation, and allocation of payments for current clients.
• Oversee the rebates billing process with manufacturers related to pharmacy and medical claims for the Medicaid Drug Rebates Program (MDRP) and supplemental rebates.
• Manage monthly review and quality assurance related to accepted claims, rejected claims, specialty drugs, billing, and payment.

Financial Planning & Analysis

• Foster a transparent and collaborative culture built upon providing sound financial planning and thoughtful analysis that supports strategic decision-making.
• Compile, communicate, and track actual performance against financial budgets and forecasts.
• Understand how different areas of the organization impact clients financially and translate this information into internal controls to ensure the completeness, accuracy, timeliness, and oversight of these activities for company SOC reports.