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Highmark Health Supervisor ASO Billing & Settlements in Des Moines, Iowa

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job is responsible for the claims invoicing and accounts receivable activities for the non-risk self-insured population of clients supporting all medical, drug, United Concordia dental, and spending account products. Primary tasks include: maintaining the weekly balancing controls and documentation relating to paid claims information from all source areas for weekly invoicing; cash application; accounts receivable management and collection activities associated to all claims billed customers; collaborating with Finance partners to assess delinquency risk resulting in the need for bad debt reserves; providing supervision and review of manual adjustments and reconciliations required to support accuarate financial reporting; ensuring all brand compliance and accounting control requirements are maintained in accordance with corporate and departmental policy; ensuring superior levels of satisfaction for internal (i.e., other business units) and external customers; ensuring that all business processes are routinely evaluated for potential elimination, automation, and/or process improvement; ensure all key performance indicators and client contractual terms are met throughout the invoice and accounts receivable process; provide subject matter expertise on enterprise and finance related projects.

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.

  • Responsible for maintaining a weekly invoice and accounts receivable cycle that ensures adherence with all compliance, audit, and financial controls. Responsible for all internal and external reporting functions, data integrity and risk management associated to the weekly cycle including executive level reporting and customized client facing reporting.Must be able to ensure the accuracy of financial records used in the weekly cycle, detect and resolve discrepancies, analyze variances to provide explanations for fluctuations and changes in trending.

  • Responsible for daily interaction with sales personnel, internal and external customers and auditors, as well as, authorized third parties representing the client. Interactions primarily focus onthe financial requirements of a self-funded contractual arrangement including use of HIPAA sensitive data and accelerated payment terms. Also, responsible for responding to various audit requests and ensuring the information provided to the auditors is reviewed for completeness and accuracy.

  • Research, review and analyze existing department processes and workflows to identify opportunities for process improvement and/or rapid process acceleration to support current and future streamling efforts geared toward overall labor or process cost reductions. Provide subject matter expertise on projects with enterprise wide stakeholders seeking complex and/or unique solutions to support the self-funded rated method. During project implementation, provideuse cases and validation of results, staff training and coordination of any policy and/or procedure changes.

  • Collaborate with department manager to review anticipated changes in work volumes driven by client growth, new rating categories, and affiliations to ensure delivery on key performance indicators and contractual requirements.

  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor's Degree in Finance, Business, Accounting or related field

Substitutions

  • 6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

  • None

EXPERIENCE

Required

  • 3 years in Customer Billing, Accounts Receivable or Collections

  • 1 year in a management or leadership role

Preferred

  • 1 year in Finance and Accounting

  • 1 year in Customer Service

  • 1 year with Process and Quality Improvement

LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

  • Demonstrates strong decision making, problem solving, analytical skills and finanical analysis required.

  • General knowledge of customer billing and/or accounts receivable management framework required.

  • Requires sound working knowledge of Excel, as well as, various computer applications and the ability to utilize technology to improve existing processes.

  • Ability to create and maintain a work environment that fosters and sustains a skilled and motivated work force. The incumbent must be effective in training, developing and empowering people, as well as, team building.

  • Possess excellent written and oral communication skills to build rapport and relationships with internal and external clients.

  • General knowledge of the medical, drug, and dental claims process, as well as, accounting principles preferred.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$57,700.00

Pay Range Maximum:

$106,700.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J217941

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