Note: The job is a remote job and is open to candidates in USA. Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. They are seeking a Senior Financial Analyst to provide financial analysis and operational oversight functions related to provider claims payments, ensuring compliance and accuracy in financial reporting.
Responsibilities
- Review and analyze weekly provider check write activity for accuracy and completeness
- Monitor and reconcile claims payments, credit memos, recoupments, hardships, levies, and payment adjustments
- Research and resolve claims payment discrepancies and out-of-balance conditions
- Perform financial analysis of claims payment trends and provider payment activity
- Prepare and present claims payment summaries and financial reports to leadership
- Validate payment files, EFT transactions, remittance advice (RA), and 835 files prior to distribution
- Collaborate with Claims, IT, and operational teams to test and implement system enhancements
- Develop and maintain reporting tools, dashboards, and reconciliations supporting claims payment operations
- Ensure compliance with accounting standards, internal controls, and regulatory requirements related to provider payments
- Support audits, financial reviews, and special projects involving claims payment processing and financial operations
Skills
- High School Diploma/GED and six (6) years of experience in Accounting/Finance/Business or financial analysis related field including analyzing financial data and preparing financial reports or preparing journal entries and performing account reconciliations; OR
- Associate's degree and four (4) years of experience in Accounting/Finance/Business or financial analysis related field including analyzing financial data and preparing financial reports or preparing journal entries and performing account reconciliations; OR
- Bachelor's degree and two (2) years of experience in Accounting/Finance/Business or financial analysis related field including analyzing financial data and preparing financial reports or preparing journal entries and performing account reconciliations; OR
- Equivalent combination of education/experience
- Must have a valid driver's license
- Must reside within North Carolina
- Must be able to travel within catchment as required
- Bachelor's degree in Accounting, Finance, or Business
- At least two (2) years in public accounting or four (4) years in accounting role(s) in the private or public sector
- Certified Public Accountant (CPA) license or in active pursuit of certification
- Experience with healthcare claims payment processing, provider payment operations, financial reconciliations, and Microsoft Dynamics 365 or a similar financial system
Benefits
- A collaborative, mission-driven work environment
- Competitive benefits and work-from-home options for most positions
- Opportunities for professional growth in a diverse inclusive culture
- Typical working hours: 8:30 am – 5:00 pm; flexible work schedules with some roles with management approval.
- Work-from-home options available for most positions
- Health Insurance with no premium for employee coverage
- Flexible Spending Accounts
- 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
- NC Local Government Retirement Pension (defined-benefit plan)
- 401k with 5% employer match and immediate vesting
- Public Service Loan Forgiveness (PSLF) qualifying employer
- Quarterly stipend for remote work supplies
Company Overview