Revenue Analyst

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Job Summary

This position is responsible for data management, submission and reconciliation of discrepancies as well as analysis and reporting for the medicare member premium received from CMS which will be used by the medicare member reconciliation manager as well as within all levels in the organization. This position is responsible for maintaining the database of all member variable data, creating, submitting compliant reports and reconciling member data from the HCSC medicare advantage population, CMS reports and submissions to CMS of member related data that affects payment from CMS computes members premium from CMS and creates necessary reports and dashboards. Imports data from CMS, plan and vendor sources and ensures data quality in reports or files submitted to CMS. This position also assists in the development and coordination of medicare advantage member enrollment and submission projects to ensure medicare member premium is accurate. Activities include resolution of medicaid status, late enrollment penalty status, medicare as secondary payment status, state and county code discrepancies related to the CMS premium management procedures, facilitating the coordination and cooperation of internal as well as external stakeholders to resolve discrepancies in matters related to CMS premium reconciliation management and the participation of other operational and financially based reconciliation activities as needed.

**This is a work from home position in Albuquerque, NM**

**You must live in or near Albuquerque for this role**

JOB REQUIREMENTS:

• Bachelors degree in Accounting, Finance, or related field 4 years experience in health care, managed care, health insurance or consulting
• Experience with overall Medicare Advantage payment methodology and CMS Payments, primarily in regard to members demographic status (i.e. Medicaid, State & County Codes), Late Enrollment Penalty, LIS, Medicare as Secondary Payer, among others.
• Experience with SQL, SAS and MS Excel including data import, manipulations and extraction, report development and ad hoc programming Analytical and verbal and written communication skills
• Ability to work with stakeholders within enterprise as well as external vendors
• Time management and multitasking skills and the ability to work with multiple deadlines

PREFERRED JOB REQUIREMENTS:

• Masters Degree or certification in Accounting, Finance, or related field Knowledge and experience on Medicare Advantage Member and Enrollment processes

We encourage people of all backgrounds and experiences to apply.

Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.

Relocation assistance will not be provided for this position.

Sponsorship will not be provided for this position

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HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.