Responsibilities
- Serve as the primary point of contact between Key Accounts Operations and Accounting/Finance for financial questions and resolution of issues
- Create, validate, and distribute client and vendor invoices in accordance with contracts and established billing cycles
- Execute monthly billing processes; validate amounts, ensure proper allocations, and correct discrepancies prior to distribution
- Maintain financial records including W-9 forms, billing documentation, contracts, and vendor account files
- Evaluate existing financial and reconciliation processes for gaps or inefficiencies; design and recommend improvements, internal controls, or automation opportunities
- Prepare data-driven presentations and reports for leadership, highlighting financial performance, operational efficiencies, and areas for corrective action
- Analyze billing, payment, and enrollment data to identify trends, anomalies, or risks; provide actionable insights and recommendations to leadership
- Generate regular and ad-hoc financial reports related to billing, payments, vendor remittances, and client activity
- Participate in program financial audits, provide relevant documentation and reports
- Collaborate with Reporting team to create and design necessary program and department financial reports to track operations spend to budget
- Develop financial projections, scenario analyses, and forecasting models to support budgeting, program planning, and decision-making
- Facilitate monthly meetings with department leaders to review financials, propose efficiencies, and assess vendor payment inconsistencies needing follow up
- Perform monthly, quarterly, and annual account and member enrollment reconciliations; calculate, identify and resolve variances in payments, remittances, enrollments, and invoice applications
- Analyze and audit enrollment data to validate accuracy of premium billing and remittances; collaborate with eligibility teams to correct inconsistencies
- Investigate and process stale-dated checks, returned payments, and NSF transactions, coordinate follow-up and resolution
- Utilize all capabilities to satisfy one mission — to enhance the competitiveness and profitability of our members
- Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively
- Be willing to adjust efforts to ensure that work and attitude are helpful to others, be self-accountable, create a positive impact, and be diligent in delivering results
- Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet
- Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data
- Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit)
- All other duties as assigned
Requirements
- BA/BS degree in Accounting, Finance, Business Administration, or a related field
- three (3) to four (4) years of experience in accounting, billing, or reconciliation within a health benefits, TPA, insurance, or healthcare services setting
- Strong understanding of health benefits billing processes, enrollment/eligibility data management, and carrier payment reconciliation
- Proficiency in Microsoft Excel, financial reporting, and ability to work with proprietary accounting or benefits administration systems
- Excellent written and oral communication skills, including the ability to produce professional reports and correspondence
- Strong analytical skills with the ability to identify root causes of discrepancies and recommend corrective actions
- Proven ability to work independently and collaboratively in a remote environment that meets company security and compliance requirements
- Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds
- Home router with wired Ethernet (wireless connections and hotspots are not permitted)
- A designated room for your office or steps taken to protect company information (e.g., facing computer towards wall, etc.)
- A functioning smoke detector, fire extinguisher, and first aid kit on site
Benefits
- profit-sharing
Work Arrangement
Hybrid
Additional Information
- Maintain internet speed of 40 MB download and 10 MB upload and router with wired Ethernet
- Maintain a HIPAA-compliant workstation and utilize appropriate security techniques to ensure HIPAA-required protection of all confidential/protected client data
- Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit)
