Billing Operations Analyst - Hybrid NY - Healthfirst
Hybrid, NY
About the Job
Duties & Responsibilities:
+ Generate and reviewtheState billing filesfor all Healthfirst products. Ensure billed records are accurate based on approved contracted rates from Department of Health and correctany errors from exception reports.
+ Ensure State billing files are loaded to the data warehouse following completion of billing process.
+ Identify and billkick events (Maternity, Newborn and Low Birth Events).
+ PreparemonthlyChild Health Plus (CHP) State voucherfor submission to State.
+ Review, analyze and create all General Ledger (GL)reports monthly (e.g., Revenue, AFDA; Write offs).
+ Ensure supporting revenue (e.g., write off data) is loaded to the data warehouse monthly.
+ Ensure State remittance files are loaded weekly and communicate any discrepancies to management in a timely manner.
+ Research and rebill denied claims across all products.
+ Submit refunds to the Department of Health forRetro Disenrollment/VOID reports.
+ Additional duties as assigned.
Minimum Qualifications:
+ Associate'sdegreefrom an accredited institution.
+ Prior work experience performing billing and accounts receivable functions.
+ Experience communicating information in both technical and user-friendly language.
+ Musthave Excel experience, the ability to create and manipulate data using pivot tables, as well as perform VLOOKUP functions.
+ Experience with SAS or SQLis a plus.
Preferred Qualifications:
+ Bachelor's degreefrom an accredited institution.
+ Ability to effectively communicate with all levels of the organization, including technical staff, internal non-technical staff, testing teams, and business stakeholders.
+ Ability to meet department standards of turnaround time and quality.
+ Ability toeffectively and efficiently work in an environment ofhigh-levelperformance.
+ Ability to challenge the status quo and drive lean implementation.
+ Excellent organization and time management skills to manage heavy workload and produce accurate information.
+ Advancedproblem-solvingskills and the ability to make critical, independent decisions within area of responsibility.
+ Ability to quickly develop an understanding of systems and technology.
Hybrid Work Schedule:
This consists of reporting to our 100 Church Street, NYC office 3 days per week.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
+ Generate and reviewtheState billing filesfor all Healthfirst products. Ensure billed records are accurate based on approved contracted rates from Department of Health and correctany errors from exception reports.
+ Ensure State billing files are loaded to the data warehouse following completion of billing process.
+ Identify and billkick events (Maternity, Newborn and Low Birth Events).
+ PreparemonthlyChild Health Plus (CHP) State voucherfor submission to State.
+ Review, analyze and create all General Ledger (GL)reports monthly (e.g., Revenue, AFDA; Write offs).
+ Ensure supporting revenue (e.g., write off data) is loaded to the data warehouse monthly.
+ Ensure State remittance files are loaded weekly and communicate any discrepancies to management in a timely manner.
+ Research and rebill denied claims across all products.
+ Submit refunds to the Department of Health forRetro Disenrollment/VOID reports.
+ Additional duties as assigned.
Minimum Qualifications:
+ Associate'sdegreefrom an accredited institution.
+ Prior work experience performing billing and accounts receivable functions.
+ Experience communicating information in both technical and user-friendly language.
+ Musthave Excel experience, the ability to create and manipulate data using pivot tables, as well as perform VLOOKUP functions.
+ Experience with SAS or SQLis a plus.
Preferred Qualifications:
+ Bachelor's degreefrom an accredited institution.
+ Ability to effectively communicate with all levels of the organization, including technical staff, internal non-technical staff, testing teams, and business stakeholders.
+ Ability to meet department standards of turnaround time and quality.
+ Ability toeffectively and efficiently work in an environment ofhigh-levelperformance.
+ Ability to challenge the status quo and drive lean implementation.
+ Excellent organization and time management skills to manage heavy workload and produce accurate information.
+ Advancedproblem-solvingskills and the ability to make critical, independent decisions within area of responsibility.
+ Ability to quickly develop an understanding of systems and technology.
Hybrid Work Schedule:
This consists of reporting to our 100 Church Street, NYC office 3 days per week.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Source : Healthfirst