Senior Financial Analyst, Premium Billing (ALD)

Job Category:  Accounting/Finance
Department:  Medical Payment System & Services
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  4665

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Senior Financial Analyst, Premium Billing is responsible for L.A. Care Covered/L.A. Care Covered Direct (LACC/LACCD and PASC Premium Billing Life Cycle and Collection process.  The Senior Financial Analyst, Premium Billing is responsible for maintaining all  premium billing weekly/monthly production reports, performs accurate member account analysis and accounts financial activity is posted accurate and timely.  The Senior Financial Analyst, Premium Billing develops and revises policies and process workflows, communicates and collaborates to provide solutions to complex business and operational issues in relation to premium billing.

Duties

Collaborates with the operational teams, such as enrollment, call center, Commercial Product Management Group and Covered Ca teams as it relates to premium billing , reconciliations with Centers for Medicare and Medicaid Services (CMS), Covered CA, and with L.A. Care affiliated bank institutions.

Collaborates with billing teams to ensure all generally accepted accounting principles (GAAP) procedures are in place for reconciliations, and for timely and accurate recording of all payments.  Ensures audit schedules are maintained. Works closely with staff to ensure Federal and State requirements are being met and maintained. Provides guidance to junior staff on more complex enrollment or billing issues.  Communicates organizational goals during team meetings. 

Develops, reviews and revises policies and procedures, desk level procedures, workflows that are in line with organizational and compliance regulations. Provides input to strategic decisions that affect the functional area of responsibility.  Ensures the operations and associated procedures of billing systems are efficient and effective for billing delivery. Develops and implements new billing solutions to improve departmental efficiency and accuracy.

Provide Accounts Receivable financial activity report, to manage team production.  Provided compliance month end reports to support productivity.

Collaborate with stakeholders to ensure accurate process improvement and automation of MPSS processes.  

Perform other duties as assigned.

Education

Bachelor's Degree

Experience

Required:
Minimum of 3-5 years Premium Billing/collection experience Healthcare experience.

At least 3-4 years of supervisory/management experience. 

Knowledge of the major responsibilities, accountabilities, and organization of the customer support function.

Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters.

Knowledge and understanding of state laws and regulations affecting insurance practices.

Knowledge of insurance products, market segments and marketplaces.

Required:
Must have a excellent verbal and written communication.

Excellent team building/interpersonal skills and strong leadership capabilities.

Must have strong accounting, analytical, and problem-solving skills.  

Must have Intermediate to Advance Microsoft Office skills, including SQL.

Ability to carry out ongoing office administration tasks effectively and efficiently.

Capable of resolving escalated issues arising from operations and requiring coordination with other departments.

Professional Certifications

Preferred:
Certified Public Accountant (CPA)

Required Training

Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)


Nearest Major Market: Los Angeles

Job Segment: Financial, Medical, Bank, Banking, Accounting, Finance, Healthcare