Kelsey-Seybold

  • Reconciliation Business Analyst

    Location US-TX-Pearland
    Posted Date 2 weeks ago(4/11/2018 9:33 PM)
    Job ID
    2018-18789
    Category
    Finance/Business Office
  • Overview

    Reconciliation Business Analyst

    Location: Pearland Administrative Office

    Department: KS Plan Advantage

    Job Type: Full time

     

    COMPANY PROFILE

    Kelsey-Seybold Clinic. Your Doctors for Life.

    Since 1949, Kelsey-Seybold Clinic has served its patients with one goal in mind – combine the expertise of physicians in a variety of medical specialties, with the close personal care of a family doctor. Kelsey-Seybold is Houston’s largest community-based physician group, caring for more than 400,000 patients. With 19 clinic locations, we are growing to meet the health care needs of our diverse patient population. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.​​

     

    JOB SUMMARY

    This position is responsible for identifying and reporting to CMS and plan delegates various payment and membership discrepancies in a timely and accurate manner. Payment discrepancies may include but are not limited to state and county code and plan type variances. This position is also responsible for submitting Coordination of Benefit discrepancies to CMS and working reports to identify payment discrepancies. This position is responsible for creating, pulling analyzing reports for internal and external audits and/or other data requests.   This position also supports enrollment activities such as daily processing of files, working daily edits and testing enrollment system updates as needed.

     

    EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS

    (A = basics; B = preferred)

     

    Education

    A.

    Associates Degree or 2 yrs equivalent work experience

     

    B.

     

    Experience

    A.

    • 3-5 years Medicare experience in enrollment, COB or finance
    • Demonstrated analytical skills including file format manipulation and data comparison
    • Demonstrated knowledge of reconciliation processes, methods and tools
    • Demonstrated knowledge of Medicare Regulations, products and processes

     

    B.

    • Demonstrated ability to analyze and report on  business units, products or service lines with minimal supervision/direction
    • Medicare Advantage plan experience preferred

    Licenses

    A.

     

     

    B.

     

    Special   Skills

    A.

    Proficient in Microsoft Excel and Microsoft Access, and 10 Key touch, Microsoft Word

     

    B.

    Proficient in Crystal Report Writing

     

    Other

    A.

    • Fluent in English both verbal and written
    • Proven ability to work in fast paced deadline-oriented environment
    • High level of accuracy with excellent attention detail
    • Superior analytical skills
    • Ability to communicate complex information in a clear and concise manner

     

    B.

     

     

    WORKING ENVIRONMENT

    Office

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