Note: The job is a remote job and is open to candidates in USA. SummaCare provides Medicare Advantage, individual and family, and commercial insurance plans. The Reconciliation Analyst develops, tests, implements, and maintains databases and reconciles payment data related to capitated payments to support commercial Exchange and Medicare business needs and appropriate risk-adjusted payments.
Responsibilities
- Develops, tests, implements, and maintains databases with respect to business applications needed to support the organizational needs of the company including but not limited to the commercial Exchange and the Medicare line of business
- Maintains and reconciles payment data related to capitated payments on and off exchange as well as supporting business needs to ensure appropriate levels of risk adjusted capitated payment per member per month
Skills
- Bachelor Degree or may substitute with 4 years of like experience
- 3+ years performing same or similar responsibilities
- Relevant experience includes: project management, database design & maintenance, development of ad-hoc reporting queries, and data analytic solutions
- Working knowledge of MS Access and database and reporting applications such as MS SQL Server applications, Query Analyzer, and Enterprise Manager, also required
- 1. Access at intermediate level
- High: ability to communicate instructional and operational information verbally and in written form that may include correspondence, reports, instructional materials, system designs; ability to provide instruction and guidance required to supervise day-to-day departmental operations; ability to interface with internal staff, mid-upper management professionals, and general public
- Complex: designing, developing, implementing complex policies, procedures, programs, technical systems that may affect more than one department
- Proofreading completed work to find and correct errors
- Requires excellent attention to detail
- 1. Maintain current knowledge of database management concepts, techniques and principles
- 2. Understands business processes and effectively translate business needs into appropriate data solutions
- 3. Apply principles of logical thinking to define problems, collect data, establish facts, draw valid conclusions, and prepare recommendations
- 4. Demonstrate strong analytical ability and attention to detail
- 5. Organize and manage time to accurately complete tasks within designated time frames in fast-paced environment
- 6. Maintain current knowledge of and comply with company policies and procedures
- 7. Maintain confidentiality of patient and business information
- 8. Flexible: ability to adjust work hours to meet business demands
- 1. Sit for prolonged periods of time
- 2. Bend, stoop, and stretch
- 3. Lift up to 20 pounds
- 4. Manual dexterity to operate computer, phone, and standard office machines
- Occasional overtime work required during peak business periods as scheduled by supervisor
- Occasional travel that may require use of personal auto to attend meetings, conferences, workshops, and/or seminars
Benefits
- Remote Opportunity
- Medical
- Dental
- Vision
- Life
- Paid time off
- Basic Life and Accidental Death & Dismemberment (AD&D)
- Supplemental Life and AD&D
- Dependent Life Insurance
- Short-Term and Long-Term Disability
- Accident Insurance, Hospital Indemnity, and Critical Illness
- Retirement Savings Plan
- Flexible Spending Accounts – Healthcare and Dependent Care
- Employee Assistance Program (EAP)
- Identity Theft Protection
- Pet Insurance
- Education Assistance
- Daily Pay
Company Overview
Company H1B Sponsorship