Revenue Analyst - Senior Products Membership Accounting
Company: TalentBoost (Point32Health)
Location: Fall River
Posted on: January 25, 2023
Job Description:
Under the general supervision of the Supervisor, Membership
Accounting, the responsibilities for this position will primarily
be the development and refinement of the analysis and
reconciliation for MSP, LIS, ESRD, Hospice and SCO to ensure
compliance with all CMS and State regulations on internal
department processes while supporting the product offerings. This
individual will demonstrate the ability to follow business
processes and consider options when problems arise and consistently
perform routine daily deliverables independently.This includes
analysis of data contained within CMS files, perform root cause
analysis to resolve discrepancies, generate and distribute revenue
reporting based on departmental protocols with an emphasis on MSP
reporting. This individual must be able to plan, organize, and
prioritize work to ensure completion in a timely manner. This
individual must demonstrate an ability to follow business
processes, to consider options when problems arise, and to identify
and escalate issues appropriately. This individual is expected to
learn and understand department processes and their inter
dependencies, contribute to process enhancement opportunities, and
support Medicare Preferred and departmental objectives.Key
Responsibilities/Duties- what you will be doing
- Expand knowledge of the monthly payments received by CMS
- Update daily/monthly records received from CMS in all systems
accordingly to match each other and to match CMS..
- Review/research data rejects
- Adjust member records and set sequences in Market Prominence
(MP), Diamond, and HealthRules Payor (HRP) - Special Status
Beneficiaries
- Work MSP (Medicare Secondary Payor) records, ensuring letters
are sent to members timely, that incoming mail is completed quickly
while updating in CMS system the responses from members. Work with
Claims department to ensure updates affecting a member's claims are
completed timely and accurately.Qualifications - what you need to
perform the jobEDUCATION, CERTIFICATION AND LICENSURE:
- Associates degree in Business; Bachelors preferred
- 1-4 years related business experience
- Financial background a plusSKILL REQUIREMENTS:
- Intermediate database and Excel skills a must
- Demonstrated ability to manage tasks independently, take
ownership of responsibilities and meet deadlines
- Strong written and oral communication skills
- Significant MS Office skills, with focus on Excel and Access at
intermediate/advanced level.
- Solid communication skills (effective verbal and written
skills).
- Strong organizational and time management skills.
- Demonstrate flexibility, commitment, and resiliency in times of
business and organizational change
- Demonstrate professional demeanor at all times
- Support collaboration across Membership Operations and other
departments and work cooperatively as a team member.
- Provide/accept constructive criticism for improvement,
including peer and supervisor feedback for performance management.
Coach others to do so.WORKING CONDITIONS AND ADDITIONAL
REQUIREMENTS (include special requirements, e.g., lifting, travel):
- This is a hybrid position requiring weekly in office 2-3
days.
- Must be able to work under normal office conditions and work
from home as required
- Work may require simultaneous use of a telephone/headset and
PC/keyboard and sitting for extended durations.
- May be required to work additional hours beyond standard work
schedule
Commitment to Diversity, Equity &
InclusionPoint32Health is committed to making diversity, equity,
and inclusion part of everything we do-from product design to the
workforce driving that innovation. Our DEI strategy is deeply
connected to our core values and will evolve as the changing nature
of work shifts. Programming, events, and an inclusion
infrastructure play a role in how we spread cultural awareness,
train people leaders on engaging with their teams and provide
parameters on how to recruit and retain talented and dynamic
talent. We welcome all applicants and qualified individuals, who
will receive consideration for employment without regard to race,
color, religion, gender, gender identity or expression, sexual
orientation, national origin, genetics, disability, age, or veteran
status.COVID PolicyPlease note: As of January 18, 2022, all
employees - including remote employees - must be fully vaccinated.
This position will require the successful candidate to show proof
of full vaccination against COVID-19. Point32Health is an equal
opportunity employer, and will consider reasonable accommodation to
those individuals who are unable to be vaccinated consistent with
federal, state, and local law.About the CompanyPoint32Health is a
leading health and wellbeing organization, delivering an
ever-better personalized health care experience to everyone in our
communities. At Point32Health, we are building on the quality,
nonprofit heritage of our founding organizations, Tufts Health Plan
and Harvard Pilgrim Health Care, where we leverage our experience
and expertise to help people find their version of healthier living
through a broad range of health plans and tools that make
navigating health and wellbeing easier.We enjoy the important work
we do every day in service to our members, partners, colleagues and
communities.This job has been posted by TalentBoost on behalf of
Point32Health. TalentBoost is committed to the fundamental
principle of equal opportunity and equal treatment for every
prospective and current employee. It is the policy of TalentBoost
not to discriminate based on race, color, national or ethnic
origin, ancestry, age, religion, creed, disability, sex and gender,
sexual orientation, gender identity and/or expression, military or
veteran status, or any other characteristic protected under
applicable federal, state or local law.Req ID:R5816
Keywords: TalentBoost (Point32Health), Fall River , Revenue Analyst - Senior Products Membership Accounting, Professions , Fall River, Massachusetts
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