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Insurance Revenue and Accounting Analyst

POSITION SUMMARY:

To be fully engaged in providing superior quality, competitive value and outstanding service and is primarily concerned with the analyzing and accounting for revenue. This position will be required to perform complex and detailed financial analysis of revenue, and act in an advisory capacity, making recommendations to management. Additionally, this position will perform peer reviews of reconciliations, journal entries and other items, as directed by management.

PRIMARY ACCOUNTABILITIES:

Engagement:

• Serve as the subject matter expert regarding revenue and reimbursements, and all premium accounting.
• Maintain GL accounts related to revenue and reimbursements by verifying data, analyzing trends, reconciling transactions, preparing journal entries and resolving all discrepancies.
• Complete account reconciliations of all Balance Sheet items related to revenue and reimbursements.
• Regularly review the P&L, providing effective and timely feedback of the revenue and reimbursements, including identifying and explaining all variances.
• Reconcile revenue and reimbursements to core systems and identify the cause of any discrepancies.
• Assist in monitoring the month-end close process to ensure timeliness of tasks.
• Provide support in ensuring the timeliness and accuracy of audit PBCs.
• Must be able to work with a high degree of independence.
• Serve as mentor to other department staff.

Quality:

• Maintain the general ledger accounting and reconciliation of Health Plan’s revenue and reimbursements.
• Prepare reports for management and other departments, as required.
• Monitor PMPM with the focus on identifying Key Drivers (as related to Revenue and Reimbursements.
• Maintain current information with respect to the accounting for Revenue and Reimbursements from GAAP and STAT perspectives and communicate significant changes to appropriate personnel.
• Prepare Notes to the Financial Statements related to revenue and reimbursements.
• Review contracts for compliance and financial implications.
• Prepare year-end audit schedules as required.
• Assist various departments in the annual budgeting process through utilization of historical projections and upcoming changes.
• Collaborate with the Actuarial Department and Billing & Enrollment Department on revenue topics.
• This position requires IT system and financial understanding and how to accurately present subledger data from multiple IT Systems.
• Review account reconciliations, journal entries, reports and other work product as requested by management.
• Review Statutory Supplemental Exhibits related to revenue and reimbursements.
• Prepare the Shared Savings Agreement Reconciliation.

Stewardship:

• Identify areas for efficiency improvements and provide Leadership with recommendations.
• Prepare financial statement account reconciliations of revenues and reimbursements that support audit requirements, internal budgeting needs, fiscal year, calendar year, line of business, and market segmentation.
• Utilize financial data analytics of revenue and reimbursements to provide information and recommendations to the Health Plans’ Leadership.

Customer Experience:

• Respond timely and accurately to requests for information and reporting.
• Participate in special projects as required.
• Responsible for meeting the close deadlines and milestones.

Qualifications:

• B.S. in business administration, finance, accounting, or related field, from an accredited college or university required. MBA or CPA desired.
• Minimum of five years of experience in general ledger accounting required.
• Minimum of three years of experience in a Health Plan or related medical field preferred.
• Minimum of three years of experience in financial analysis.
• Overall understanding of financial systems used, including the incoming and outgoing EDI transmissions of data, the posting of financial data between multiple computer systems, and the configuration tables within the computer systems.
• Prior experience and knowledge in the use of Peoplesoft preferred.
• Proficient in Microsoft Office products (SQL, Excel, PowerPoint, Word, Outlook)
• Time management and priority setting skills
• Possess excellent analytical and problem-solving skills.
• Possess strong computer abilities and communication skills.
• Demonstrates the ability to relate well with all customers and peers.
• Ability to prioritize and organize to maximize quality, value, and service.

COMPETENCY ASSESSMENT/SKILLS CHECKLIST:

• Demonstrated ability to relate well to others in a variety of functional areas.
• Mature approach to problem-solving for all types of issues.
• Highly motivated and able to take initiative.
• Strong knowledge of computer systems.
• Demonstrated ability to problem solve and think both creatively and analytically.
• Demonstrated effective oral, written, and interpersonal communication skills.
• Must exhibit superior analytical and problem-solving skills.
• Ability to extract data using Microsoft SQL.
• Ability to assist Leadership, Corporate Finance, and the Financial Services department with various projects on an as needed basis.