Your Role
The Self-Funded Finance team who handles the claims billing for all Self-Funded groups.
The Financial Analyst, Experienced will report to the Self-Funded Finance Manager.
In this role you will be Assisting with Group set ups from implementation to go live.
Assist with ad-hoc reporting and various Self-Funded projects.
Assist with department audits, month end reporting, and other various tasks.Your Work
In this role, you will:
Summarize detailed revenue/expense data and compare summarized claim data against fee schedules and contracts
Produce contract performance reports, modeling of reimbursement rates, evaluation of financial contract modifications and compiling and monitoring key managed care statistics
Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to forecast balance sheet, cash flow and regulatory capital
Follow and conduct audit processes and review internal controls to ensure financial transactions are accurate, timely and comply with accounting standards, principles and company policy
Provide policy guidance and interpretation to ensure financial records are consistent and comply with company policies and GAAP
Analyze and audit weekly client invoices
Manage set ups, active accounts, and termination for assigned clients
Perform weekly and monthly reconciliation of banking, and claims activity
Maintain and create department desk level procedures
Partner with IT to resolve systematical issues
Your Knowledge and Experience
Requires a bachelor's degree or equivalent experience
Requires at least 5 years of prior relevant experience
Facets claims system experience desired
Claims knowledge desired
Pay Range: The pay range for this role is $71,280.00 to $99,770.00 for California.
Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.
Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.