Provides financial, administrative, and clerical support within the Accounting/Finance department
Responsible for review and processing of vendor invoices, provider payments, and voids and reissues of provider payments
Premium Billing - processes the monthly premium billing cycle for ASO PEPM fees and Medicare Advantage enrollees
Reconciles invoices and premium receipt reports to premium billing reports
Reconciles and applies payments received for premium invoices
CRM Responsibilities - Research, resolve and communicate resolution to internal team as well as external vendors for any finance related customer relationship management (CRM) request(s)
Claims Funding - Communicates weekly claims funding totals for both capitated and non-capitated claims to ASO clients as part of the weekly claims settlement process
Claims Settlement Analytics - Provides management with weekly claims settlement analytics and reports
Manages vendor information for accuracy relating to address and banking information to ensure payments to vendors are received and/or processed in a timely fashion
Compiles and processes accounts payable, maintains day to day payment cycle, and provides efficient customer service
Ensure all Medicare Advantage claims are settled and processed in a timely manner to avoid penalty
Verify approval on all vendor payment requests
Process payments to contracted providers for claims submitted to and processed by the Claims Operations department
Resolves problems associated with vendor payables transactions
Reconciles processed work by verifying entries and comparing system reports to balances
Provides accurate and effective document preparation and records management relative to the Claims Payable function in accordance with records retention policies and procedures, and any federal regulations
Maintain relationships will all areas of the organization to ensure effective, efficient, and accurate workflow processes as it relates to claims processing and customer service to both internal and external clients
Protects organization’s value by keeping information confidential. Adere to all HIPPA regulations
Updates job knowledge by participating in educational opportunities
Maintains historical records by imaging and filing documents
Requirements
Associates’ Degree in finance, accounting or business related field
Two (2) years of accounting or finance related experience
Benefits
Hybrid (2-3 days on-site)
40 scheduled weekly hours
Exempt/Non-Exempt: United States of America (Non-Exempt)
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