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Senior Settlements Analyst

Company: CareFirst BlueCross BlueShield
Location: Owings Mills
Posted on: August 3, 2020

Job Description:

Resp & Qualifications The Senior Settlement Analyst is responsible for the invoicing and accounts receivable activities for groups with special funding arrangements, including both risk and non-risk retrospective arrangements, administrative services only (ASO), and specific and/or aggregate stop loss. The Senior Settlement Analyst will handle a book of business consisting of approximately 30 accounts, generating $250-$749 million in annual revenue. This is a unique, high profile position which requires the incumbent to interact with Customers, Sales Representatives, Underwriting, external partners including Brokers and Consultants, Finance, Strategic Business Units (SBUs), and Technical Operations Support (TOS), to ensure the continued accuracy and completeness of invoices, invoice reporting, and accounting for non-fully insured rating arrangements.PRINCIPAL ACCOUNTABILITIES:Under the general supervision of the Manager, Account Financial Settlements, the incumbents principle accountabilities include, but are not limited to, the following:Prepare weekly claim settlements associated with special funding arrangements for assigned accounts, including client notification and submission of required reporting within the time frame established by the financial contract. Provide assistance to technical support staff and management in the resolution of issues that may impact timely client invoice/payment notification and/or client submission of funds to fulfill funding arrangements. The incumbent should demonstrate a clear understanding of the impact of issues on overall business operations.Complete monthly, annual and/or retrospective settlements for increasingly difficult accounts, including those that require more complex tracking of payments and aging of receivables. These complex accounts may be split platform (products on more than one adjudication system), may have multiple billing entities, multiple payments per invoice, or mixed funding arrangements. Compile summary and detail claim reports, enrollment data, confirmation of client remittances and control reporting to validate the accuracy of settlement data. Calculate administrative fees and other charges to complete financial settlements. Identify account and process level issues and move toward completion. Prepare monthly and annual adjusting journal entries (JEs) associated with retrospective settlements, including IBNR impact. Format claims data and reporting for selected accounts. After obtaining management approval, issue monthly and annual settlements and the related supporting documentation to the respective accounts.Provide support to the month end accounting close through the accurate and timely analysis of settlement activity and submission of gain/loss reporting. Accurately enter monthly settlements into the Oracle Accounts Receivable Module, apply cash receipts to the appropriate client invoices and analyze the respective balances. Clear any reconciling items and correct errors, if any, within 60 days of the invoice date. Prepare accurate and timely journal entries and reconciliations of accounts controlled by the business unit.Run jobs, programs, scripts and/or reports that are critical to business operations. Run the weekly billing process, enter control information for monthly billing programs, run global monthly reports, and perform balancing/testing on the results.Provide customer service to internal and external customers including billing requirements, claims analysis, and explanation of complex AR balances.. Compile direct costs and prepare the annual Employee Retirement Income Security Act (ERISA), Form 5500, Schedule C, and ensure timely account distribution.Participate in special projects aimed at process improvements and/or enhancement of existing business practices including those internal to the Settlements department, and those that may impact other departments (e.g. Finance, Underwriting).Provide training support, mentoring, and guidance to less experienced staff members on weekly and monthly invoicing activities.QUALIFICATION REQUIREMENTS:Required: This position requires a bachelors degree in Business Administration, Finance or a related field or equivalent experience. This position also requires a minimum of 3 years of progressively responsible experience invoicing and performing accounts receivable activities for groups with special funding arrangements. Candidate must have strong computer skills and demonstrate proficiency in Microsoft Excel, and MS Word. Preferred candidate will be familiar with CareFirst product portfolio, and CareFirst enrollment, claims and reporting systems.The successful candidate will possess the following: Ability to work independently and as part of a team. Attention to detail and excellent analytical and problem-solving skills. Excellent interpersonal skills including the ability to build consensus and agreement and bring issues to resolution. Strong organizational skills including the ability to set priorities and handle multiple tasks concurrently. Ability to accept additional roles and responsibilities and manage change.Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of theCompany to provide equal employment opportunities to allqualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.Hire Range Disclaimer Actual salary will be based on relevant job experience and work history.Where To Apply Please visit our website to apply: www.carefirst.com/careersClosing Date Please apply before: 8/15/2020Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.PHYSICAL DEMANDS:The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.Sponsorship in US Must be eligible to work in the U.S. without Sponsorshipby Jobble

Keywords: CareFirst BlueCross BlueShield, Baltimore , Senior Settlements Analyst, Accounting, Auditing , Owings Mills, Maryland

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