LOCATION: Henderson Road, Tampa, FL
REPORTING TO: Senior Manager Revenue Reconciliation
Reconciles memberships and premiums between the Health Plan and government partners. Conducts timely reporting, offers process improvement recommendations, and works collaboratively on the reconciliation processes for WellCare's membership to ensure we receive the appropriate premium. Works closely with service partners within the Corporate/Regional sites and develops business contacts as deemed appropriate.
Additional Responsibilities:Candidate Education:
- Multi-tasks using multiple internal and external applications to identify and research monthly premium discrepancies between expected premium and actual payments.
- Downloads reconciliation results into management reporting tools and performs the tracking, research and resolution of identified discrepancies.
- Engages in membership eligibility research, requiring critical thinking skills and the ability to analyze and resolve payment discrepancies, to maximize the collection of accurate revenue.
- Provides management with monthly established Financial Indicators.
- Quantifies and documents revenue implications of payment discrepancies.
- Contributes to the development and documentation of reconciliation workflows and educational tools used to facilitate cross training and internal controls.
- Required A High School or GED
- Preferred Other Some college curriculum a plus
- Required 2 years of experience in Any combination of Reconciliation, Auditing, Accounting, or Member Enrollment experience
- Preferred Other Health insurance experience; prior experience with government program regulations, 1 years government payer system experience, and/or Xcyels experience is a plus
Licenses and Certifications:
- Intermediate Demonstrated analytical skills
- Intermediate Demonstrated problem solving skills
- Intermediate Other Detail oriented
A license in one of the following is required:
- Required Intermediate Microsoft Excel
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft Access
- Required Intermediate Microsoft PowerPoint
- Preferred Intermediate Other Paradigm and Sidewinder