The Manager, Self Funded Billing is responsible for the oversight of the self-funded claims and administration fees billing function. The Manager will use substantial judgment in determining approach and methodology to be used for all key responsibilities. The position will make recommendations for process improvements in line with HealthNow goals and objectives that will create efficiencies and improve profitability. This role reports to the Director of Finance and supervises a team of analysts; in this capacity, the manager provides leadership through coaching and mentoring and ensures staff has strategically aligned business and development goals. The Self-Funded Billing Manager consistently displays professional enthusiasm and initiative to enhance and improve processes, controls and, overall, the success of the organization.
Primary Job Duties:
- Manage a team of analysts responsible for the accurate and timely billing of all self-funded claims, capitation, vendor and administration fees. Perform detailed review of key accounts' invoices and all general ledger entries and balancing sheets. (20%)
- Manage account setup for self-funded group renewals and new sales. Ensure accuracy of fees in PeopleSoft or other internal systems as well as proper coding to general ledger accounts. Work closely with sales personnel and account retention teams to coordinate and assist in the completion of all billing requirements documents in advance of the intended effective date. (10%)
- Act as a liaison between Business Unit Finance and New Sales/Account Management teams, Actuarial and Corporate Finance/Accounting. Drive efficiencies across the organization and advocate change that will enhance the overall success and profitability of the organization. Manage the annual pricing update effort. (10%)
- Devise and develop automated solutions to manual tasks. Ensure proper controls and checks/balances are in place to maintain integrity of data. (20%)
- Manage all interactions with external customers, with a focus on building relationships and providing timely responses to inquiries. Manage customer accounts and assist with the collection effort of delinquent balances. (10%)
- Ensure process and procedures documentation is regularly updated and reflective of current policy at all times. Maintain compliance with SSAE 16 metrics and requirements. Enhance and improve controls in all relevant areas for audit compliance purposes. (10%)
- Responsible for the generation of regular group-level profitability reports and analyses; manage the generation and completion of all ad-hoc report requests. Work closely with the Director, Finance to create memorandums, graphical presentations and financial reports for submission to executive management. (10%)
- Manage a team of analysts and provide continual coaching and skills development. Monitor performance against goals, provide feedback and assess and differentiate performance. Encourage innovative thinking and initiative in actions by the team. (10%)
- Performs other duties as necessary.
Bachelors Degree (Accounting,Economics,Finance,Mathematics,Statistics)
- Exceptional analytical, organization, and time management skills
- Keen attention to detail
- Exceptional verbal and written communication skills
- Ability to resolve issues and effect change
- Results-oriented with desire to constantly improve processes
- Outstanding skills with standard Microsoft Office applications (especially Excel and Access, also PowerPoint and Word) and ability to coach staff in this area.
- High degree of business maturity and demonstrated confidentiality
- Polished, professional image and reputation
- Demonstrated personal accountability
- High energy level and ability to project enthusiasm
- Strategic thinking/planning skills
- Demonstrated leadership skills (coaching, mentoring, staff development)
MBA and/or other advanced certifications preferred. Minimum 5 years related work experience, with healthcare or health insurance industry experience preferred.
- Must be able to work in an office environment
HealthNow New York Inc. - 19 months ago
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