Premium Billing Analyst III in Norfolk, VA at Beacon Health Options

Date Posted: 7/22/2018

Job Snapshot

Job Description

ABOUT THE POSITION:

The Premium Billing Analyst is responsible for executing all functions associated with daily claims production check runs. Examines and allocates received funds to the appropriate client bank accounts.  Monitors daily ASO bank account balances. Authenticates and releases all eligible check runs. Reviews and determines all positive pay exceptions.  Validates and executes all stop payments. Investigates any possible fraud issues.  Invoices clients, maintains void and refund information on the client fund statements and all financial reporting for the client. Manages escalated issues via Corporate Finance mailbox.  Responsible for completing all customer service inquiries, to include processing of stop payments. Manages audit requests and the 1099 hotline.  Supports Claims Disbursement Supervisor and all Premium Billing functions.  This position must strictly adhere to HIPAA regulations pertaining to all financial and PHI disclosures. The PBA III position requires a level of security that includes live checks storage, MICR and software protection.

About the Position:

  • Process all claim transactions in the CAS or FlexCare systems.  Records totals for posting reconciliation. Reviews all scheduled clients to ensure their eligibility for processing in the daily check run.  Once verified execute check run processing for the clients.  Generates and transmits all positive pay files to appropriate bank.
  • Generates funding reports via secure internet website for ASO clients to include the beginning bank balance report, wire report and ACH report.  Examines and allocates received funds to the appropriate clients.  Investigates all discrepancies between funding report and fund statements.  Validates beginning balance report to ensure no accounts are in a possible overdraft situation and investigates and resolves or escalates findings.
  • Authenticates that daily check runs are funded correctly and eligible for release.   Releases all authenticated check runs via secure outsourcing vendor website. Performs any reroutes as requested within the guidelines of the Finance Policy and Procedures.   
  • Reviews all positive pay exceptions via secure banking websites and determines all exceptions prior to banking deadline.
  • Validates all stop payment requests and executes via secured banking website.
  • Investigates any possible fraud issues; coordinates with the treasury department, and initiates formal bank investigations as necessary.
  • Responsible for all associated duties for assigned clients to include invoicing, reconciling fund statements, and processing special reporting as required.  All special reports must be validated against the check register and any discrepancies must be investigated and resolved prior to finalizing the invoice within the contractual time frame. All invoicing correspond must strictly adhering to HIPAA regulations pertaining to both Financial and PHI disclosures.
  • Manages all escalated issues within the Corporate Finance mailbox ensuring that all items are addressed within 48 hours.
  • Examines customer service inquiries, investigating as necessary to perform check traces, stop payments and regeneration of financial documents within guidelines established in the finance policies and procedures
  • Supports Claims Disbursement Supervisor as needed.  Manages supplies and order as necessary, including check stock, envelopes and general office supplies.
  • Manages audit requests to ensure they are completed within required deadline
  • Manages 1099 hotline – logs all calls and distributes work evenly to the finance staff for research and resolution.  Contact providers regarding 1099 inquires, researching raised issues and processing reconciliation reports as warranted.   Authenticates all names and TINs match Internal Revenue Service records.
  • Troubleshoots all inter-departmental requests regarding any issues as presented.
  • Monitors assigned clients’ funding patterns according to the established guidelines in the finance policies and procedures. Responsible for initiating all necessary actions for clients who fall outside the established guidelines.
  • Supports all Premium Billing Analyst functions.

 Position Requirements:

  • Education: A High school diploma or equivalent required.  Some college preferred.
  • Relevant Work Experience: Five (5) years of MS Excel experience to include data manipulation, creating reports, pivot tables, and using macros.

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disable