Skip Navigation

Senior Revenue Reconciliation Analyst

Pittsburgh, Pennsylvania Apply Now Job ID 1187537 Additional Locations Pennsylvania,Pennsylvania,US;Harrisburg,Pennsylvania,US Category Accounting & Finance Organization Pennsylvania Health and Wellness Schedule Full-time
Description:
Position Purpose: Position acts as a subject matter expert on the process of reconciling membership and premium between WellCare and government partners. Ensures timely reporting, process improvement and the ability to work collaboratively on the reconciliation processes for WellCare's membership to ensure we receive the appropriate premium. Ownership for all aspects of the reconciliation process and the timely resolution for all outstanding discrepancies will fall under this position. Works very closely with the Markets, Actuaries, Accounting, Enrollment, and IT partners within the Corporate/Regional sites and develop business contacts as deemed appropriate. Reviews work done by other team members, assists with coaching and training other associates and provides direct support to the manager position. Candidate Education: Required A High School or GED

Essential Functions: * Multi-tasks using multiple internal and external applications to identify and research monthly premium discrepancies between expected premium and actual payments, with minimal supervision.
* 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.
* Reports revenue and other financial data to the accounting department for monthly close activities. Provides Management with monthly established Financial Indicators.
* Quantifies and documents revenue implications of payment discrepancies.
* Prepares detail and summary level reports including written interpretation of analytic results.
* Contributes to the development and documentation of reconciliation workflows and educational tools used to facilitate cross-training and internal controls. Provides review/coaching/training functions as needed for other associates.
* Develops relationships with key members of other WellCare departments to communicate errors/issues in a timely manner.
* Responsible for teaming with the business units to identify trend outliers and performs the work necessary to facilitate discussion and possible solutions.
* Provides independent appraisals, analysis, observations and communicates issues clearly and confidently with management and other departments.
* Provides reporting and ad hoc query analysis. Makes recommendations for reporting, process or operational improvements and drives for implementation.
* Assists with design/requirements and performs testing on new releases of internal applications.
* Collects required data for any internal or external audit requests.
* Assists management on team decisions such as work load distribution, timing of specific processes, and associate development suggestions.
* Performs other duties as assigned.Additional Responsibilities:
Qualifications:
Preferred A Bachelor's Degree in a related field may substitute for 2 years experience in any combination of Reconciliation, Auditing, Accounting or AnalyticsCandidate Experience: Required 3+ years of experience in any combination of Reconciliation, Auditing, Accounting, or Analytics
Preferred 2+ years of experience in government payer systems
Preferred 1+ year of experience in Health insurance
Preferred 1+ year of experience in Xcelys
Preferred 1+ year of experience in government program regulations Licenses and Certifications:A license in one of the following is required:

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Apply Now

Check out this location

See what's near our Pittsburgh location.

View Map

Our Hiring Process

Learn more about our hiring process and discover other helpful information for applicants.

Learn More

Sign up for Job Alerts

Join our Talent Network and get Centene news and job alerts delivered to your inbox.

Areas of InterestSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

  • Accounting & Finance, Pennsylvania, United StatesRemove
  • Accounting & Finance, Pittsburgh, Pennsylvania, United StatesRemove
  • Accounting & Finance, Harrisburg, Pennsylvania, United StatesRemove

Match Your Skills

Let us search jobs for you based on the skills and experience listed in your LinkedIn Profile.

Start Matching
Protect Yourself From Fraud