Finance Ops Analyst II - Compliance
Who We Are
Point32Health 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. To learn more about who we are at Point32Health, click here.
Job SummaryUnder the direction of the Sr Manager, Finance Operations, The Finance Operations Analyst II, is responsible for the execution of multiple and complex operational processes associated with Claims Disbursements, Provider Collections and Corporate Accounting Operations. The Analyst II ensures timely and accurate completion of claims validation and release, provider refunds, Invoice processing, account reconciliations and banking activities, as well as regulatory processes and monthly metrics. The Analyst participates in key Finance Operations initiatives, including but not limited to operational improvements, new product development and implementation, new vendor partnership implementations and technological advancements. This position requires a strong business and technical skills with the ability to work across multiple systems/interfaces. This is a cross functional role that interacts with internal and external business partners, requiring strong communication skills.
Key Responsibilities/Duties – what you will be doing
FINANCE OPERATIONS ANALYST II RESPONSIBILITIES:
- Perform accurate completion of production cycles and related processes within prescribed deadlines, including reconciliations, and control reporting.
- Identify production issues and coordinate resolution with management and team members, internal/external business partners, and IT.
- Analyze data, validate, interpret results, and communicate results effectively.
- Develop and maintain highly collaborative working relationships with the internal and external stakeholders and business partners
- Assist with corporate projects and departmental initiates to ensure successful implementation and integration of all business processes. Interact effectively with Program and Project Managers and assist with other department projects as needed.
- Assist with ongoing system maintenance, configuration, and enhancements.
- Update and maintain policies, procedures, and workflows.
- Perform cross-training, implement process improvements, and ensure corporate controls and polices are adhered to.
- Responsible for responding to internal and external audit requests
- Provide superior customer service to internal and external customers.
- Perform operational activities associated with claims-related disbursements and banking arrangements, invoice payment, and other financial disbursements
- Work in coordination with other departments on the processing of provider refunds or payments, and the reconciliation and closing of those transactions from the financial perspective
- Research transactions associated with claims, enrollments, cash/accounts receivable, and payments to facilitate correct transaction processing
- Triages and follows up on weekly rejects related to claim payments
- Assists in the month-end closing activities, and the analysis and reconciliation of data associated with those processes
- Process transactions associated with unclaimed property, including tracking, organizing, and prioritizing the work
- Assist with 1099 MISC/NEC/INT reconciliations and processes
- Create and report monthly metrics associated with their own and the team’s work
- Manage the monthly supplier and invoice hold report and reconciliation process
Qualifications – what you need to perform the job
EDUCATION: (Minimum education & certifications required)
- Bachelor’s degree in accounting or business administration required.
EXPERIENCE: (Years of experience)
- 2-3 years of accounting or finance work experience which demonstrates the abilities to perform in the position. Managed health care experience is preferred, operations and/or analytical experience a plus
SKILL REQUIREMENTS: (Include interpersonal skills)
- Highly organized with exceptional attention to detail
- Ability to follow up/follow through to ensure timely accurate completion of tasks
- Strong problem-solving and investigative skills required
- Ability to prioritize work, manage multiple tasks and meet deadlines operating under very tight timelines
- Strong work ethic, desire to learn and be challenged, self-motivated with the ability to work independently with a bias for taking initiative
- Proficiency with Microsoft suite of products. Mastery in use of Microsoft Excel. Oracle eBusiness experience is highly desirable.
- Excellent written and verbal communication skills
- Personable, able to collaborate as a colleague and business partner to interact with peers and internal/external stakeholders
- Discretion and confidentiality
Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity
Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's 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.