Posted
7 weeks 3 days ago
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Job Description
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At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
Job Summary
This position is responsible for data management, submission and reconciliation of discrepancies as well as analysis and reporting for government programs member premium received from CMS and the States (IL, NM, TX) which will be used by the Revenue Manager as well as within all levels in the organization. This position is responsible for reconciling member data from the HCSC government programs population, reports and submissions to CMS and the States (IL, NM, TX) of member related data that affects payment, computes members' premium, and creates necessary reports. Imports data from government programs sources, plan and vendor sources and ensures data quality in reports or files submitted. This position also assists in the development and coordination of government programs member enrollment and submission projects to ensure member premium is accurate. Activities include resolution of discrepancies related to the government programs premium management procedures, facilitating the coordination and cooperation of internal as well as external stakeholders to resolve discrepancies in matters related to CMS and the States (IL, NM, TX) premium reconciliation management and the participation of other operational and financially based reconciliation activities as needed such as MAR Control Adherence and Testing.
JOB REQUIREMENTS:
* Bachelor's degree in Accounting, Finance, or related field or1 year experience in health care, managed care, health insurance or consulting
* Intermediate Excel knowledge
* Analytical and verbal and written communication skills
* Ability to work with stakeholders within enterprise as well as external vendors
* Time management and multitasking skills and the ability to work with multiple deadlines
PREFERRED JOB REQUIREMENTS:
* Knowledge and experience on States (IL, NM, TX) Medicaid Member and Enrollment processes
* Experience with overall States (IL, NM, TX) Medicaid payment methodology
* Expert In MS Excel including data import, manipulations and extraction, report development and ad hoc programming
* Experience with POWER BI and HCSC FACETS
* This is a hybrid role requiring 3 days in the office and 2 days remote weekly.
We encourage people of all backgrounds and experiences to apply. Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
#LI-Hybrid
#LI-EL1
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$39,900.00 - $88,800.00
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