The Reconciliation Analyst is responsible for conducting complex reconciliation activities related to Medicare payments. This position is responsible for analyzing, researching and resolving moderate to complex issues and variances arising from Medicare overpayment/underpayment, appeal and/or other adjustments related to providers. Validating appropriate processing and conducting downstream impact analysis of payments posted, reversed, adjusted and appeals as an essential function of this position. Other responsibilities include and keeping current with CMS contractual requirements and regulations.
• Review & research a high volume of transactions, identifying causes of discrepancies & recognize resolutions, document issues & report to management
• Complete from start to finish all invoice processing and reconciliation
• Interface and communicate with technical departments regarding reconciliation of a high volume of transactions and data
• Assess process inefficiencies; provide detailed input as to the approach & programming required to enhance & improve process, capture appropriate data
• Provide analytical audit assistance with CMS audits, supporting action plans for improvements as identified by management
• Complete all tasks & projects assigned with both speed and accuracy
• Ability to handle changing situations and work within a diverse group
• Perform ongoing quality assurance functions and ability to recognize interdependencies
• Provide recommendations to management on work-flow and processing improvements for efficiency and accuracy
• Complete accurately & efficiently any and all tasks as assigned by the department management
• Perform other incidentals and related duties as required and assigned.
Required Skills and Knowledge:
• Illustrate strong reconciliation techniques
• Excellent knowledge of data entry practices, principles, methods & techniques
• Demonstrate proven analytical and organizational skills
• Demonstrate strong written & interpersonal communication skills
• Ability to easily flex between competing priorities in workload or change in deadlines
• 5+ years in a senior team member and/or leadership role
• High level of ability to multi-task in handling multiple projects
• Strong MS Excel, Access and Word capabilities
• Ability to maintain strict confidentiality and secure approach in handling of data
• Able to work efficiently independently
• Experience with Medicare & CMS or within a Medicare managed healthcare plan – a plus
• Hands on experience within Medicare & CMS invoicing, claims and/or provider payment processing
• Minimal traveling required
• Sit/stand/walk 8-12hr/day
• Lift/carry/push/pull under and over 10lbs occasionally
• Keying frequently, handling, reaching, fine manipulation
Education and Experience:
• Degree and/or 3+years of relevant health insurance, billing, invoice or reconciliation environment
• 3-5 years’ work experience in a complex invoice/billing
• AA or equivalent combination of work experience & education (5+ years)
Performant Financial Corporation is an Equal Opportunity Employer.
Performant Financial Corporation is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
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