Description
Summary- The Medical Payment Systems and Services Senior Financial Analyst, is responsible for management and preparation of all month end financial activity reports.
- They will review and provide detailed explanation of variance report to support trend analysis on Revenue, Capitation, shared Risk and claims and pharmacy.
- They will provide ad Hoc analysis to support operational requests as they relate to the product lines and/or implemented pilots, contracts with participating physician groups (PPGs), hospitals and ancillary providers.
- The position will work with Financial Compliance on rate setting, PPG audits and Internal/External audits.
- They will work very close with other departments to coordinate reporting requests and ensure a complete understanding of variances is be documented.
- The position will work with the Revenue unit to validate the Medicare HCC scores.
Qualifications
- They must be familiar with claim CPT/ICD 9 code
- Must have Medicare and Medi-Cal knowledge.
- The successful candidate must demonstrate excellent communication skills, have strong healthcare, and analytical skills, and excellent database skills ie excel, MS Access, SQL, QNXT and MHC knowledge preferred.
- Must have a Bachelors in Business Administration or Finance, will accept comparable work experience, with knowledge of accounting and a minimum of 3 to 5 years working in a Healthcare setting.
- 3 to 5 years of experience, Medicare and Medi-Cal knowledge and knowledge of claim CPT/HCPC/Revenue Codes, ICD-9/ICD-10 codes, and POS/Bill Type codes and Managed Care experience.
- Expertise in Excel and good knowledge of Microsoft Access and preferably SQL.
- Bachelors Degree in Finance, Business Administration, or Accounting