What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Reporting to the Supervisor of Finance Analytics - Commercial Finance, the Financial Analyst III - Commercial Finance will lead and/or complete a variety of complex high-level duties related to financial reconciliation of premium invoicing and payments from various sources, monitoring of BPO vendor, collaborating with cross-departmental teams to resolve payments issues, and ad-hoc analysis as it relates to the commercial products. This role will work with large data sets and develop complex SQL queries. This position will independently identify issues, problem-solve, and communicate effectively (both written and verbal).
Key Responsibilities:
1. Monitor and respond to 2nd level inquiries related to payment reconciliation and/or any other issues.
2. Analyze complex over- or under-premium payments and submit findings for leadership review.
3. Perform 2nd level research into member premium issues and/discrepancies and provides recommendations on solutions.
4. Program complex SQL queries to perform reconciliation of various revenue streams (i.e.: Member payments, APTC payments, state credit/subsidies) to ensure Member accounts are accurate.
5. Resolve complex payment disputes received from the merchant services vendor and lockbox decisioning items received from bank lockbox to ensure funds are accurately applied to member accounts in a timely manner.
6. Review work output/deliverables of lower-level analyst on the team.
7. Work with 3rd party print vendor to create/update all premium related notifications, as required by regulatory guidelines.
8. Provide in-depth moderate to complex business requirements to BPO vendor for programming modifications related to premium invoicing and/or other business needs.
9. Lead discussions on root-cause analysis regarding systems/software and process issues regarding premium and invoicing workflows.
10. Perform detailed analysis of refund requests and/or overpayments and process member refunds.
11. Perform verification of internal and external broker commission payments to ensure accuracy of payments.
12. Prepare month end reports and/or journal entries for monthly financial reporting and management reporting requirements.
13. Perform accurate interpretation of complex regulatory requirements as it pertains to premium billing activities, member notices as it relates to member premiums, and revenue reconciliation requirements.
14. Act as a trusted resource for the organization and consistently demonstrates IEHP organizational values while building and maintaining strong internal relationships.
15. Demonstrate a commitment to incorporate LEAN principles into daily work.
16. Design, create and maintain processes to ensure compliance with commercial regulations.
17. Partner in ensuring quality and accuracy of the work deliverables are maintained.
18. Any other duties as required ensuring Health Plan operations are successful.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
Education & Experience
Key Qualifications
Start your journey towards a thriving future with IEHP and apply TODAY!
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