Duties and Responsibilities:
Generate and review the State billing files for all Healthfirst products. Ensure billed records are accurate based on approved contracted rates from Department of Health and correct any errors from exception reports.
Ensure State billing files are loaded to the data warehouse following completion of billing process.
Identify and bill kick events (Maternity, Newborn and Low Birth Events).
Prepare monthly Child Health Plus (CHP) State voucher for 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 for Retro Disenrollment/VOID reports.
Additional duties as assigned.
Minimum Qualifications:
Associate's degree from an accredited institution.
Prior work experience performing billing and accounts receivable functions.
Experience communicating information in both technical and user-friendly language.
Must have Excel experience, the ability to create and manipulate data using pivot tables, as well as perform VLOOKUP functions.
Experience with SAS or SQL is a plus.
Preferred Qualifications:
Bachelor's degree from 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 to effectively and efficiently work in an environment of high-level performance.
Ability to challenge the status quo and drive lean implementation.
Excellent organization and time management skills to manage heavy workload and produce accurate information.
Advanced problem-solving skills and the ability to make critical, independent decisions within area of responsibility.
-Ability to quickly develop an understanding of systems and technology.
Compliance & Regulatory Responsibilities: N/A
License/Certification: NA
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $57,400 - $78,030
All Other Locations (within approved locations): $49,800 - $74,120
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.