Offer summary

Qualifications:

High school diploma or equivalent required, with some secondary education preferred., Exposure to finance and/or accounting principles is beneficial., Strong organizational, self-motivation, and decision-making skills are essential., Proficiency in Microsoft programs, particularly Excel and Access, is required..

Key responsibilities:

Oversee the administrative processes for client claims billing, funding, and stop loss filing.

Maintain accurate records and documentation related to client funding and reimbursement requests.

Address inquiries from stop loss carriers and ensure timely submission of required documentation.

Evaluate and implement process improvements to enhance operational efficiency.

Job description

Position Summary:

The Finance Operations Coordinator is an experienced professional with proven skills in third party claims administration and a working knowledge of related processes. The primary responsibility of this position is the complete administrative oversight of the client’s claims billing, funding, and stop loss filing & reimbursement processes. This team member should operate in a manner that is consistent with the MedCost mission statement, work to meet or exceed performance measures and goals, and meet customer’s needs.

Position Responsibilities:

Notify client of check run, amounts, provide check registers and authorization form.
Maintain documents such as verification of client check run, funding date and release of payments and EOB’s/ERA.
Keep accurate records of client funding expectations and reporting needs.
Submit Specific and Aggregate reimbursement requests to stop loss insurance carriers accurately and timely, following standard operating procedures.
Administer advance funding when included in a group’s stop loss policy
Efficiently address questions and requests for information from the stop loss carriers and gather all supporting documentation from corresponding departments as necessary
Reconcile monthly and year end reporting to reflect reimbursements, refunds, voids, etc.
Research client issues relating to inquiries and/or delinquency outside of the normal process.
Research payment status and process voids as needed.
Follow all policies and procedures established for the department.
Develop and maintain excellent working relationships with all internal and external contacts.
Assist co-workers as needed in reaching department goals.
Understand and appreciate the need for a sense of urgency and accuracy with all work activities and communicate appropriately with department leadership to coordinate response/resolution.
Meet and/or exceed all defined performance expectations at an individual and department level.
Evaluate opportunities for process improvement and implement solutions producing desired outcomes
Other duties as assigned.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Positions Qualifications:

Required

High school diploma or equivalent required

Preferred

Some secondary education
Exposure to finance and/or accounting principles

Skills, Knowledge And Abilities

High degree of accuracy
Excellent oral and written communication skills
Exceptional customer service, and interpersonal skills
Effective problem-solving and influencing skills
Familiarity with the key principals of Lean continuous process improvement
Strong organizational, self-motivation, and decision-making skills
Proficiency using Microsoft programs (primarily Excel and Access)
Ability to manage multiple priorities in a fast-paced environment
Ability to work independently and collaboratively, as needed
Ability to identify areas which put MBS and/or our client financially at risk
Understanding of data exports

Key Competencies

Service orientation
Integrity
Ethical practice and confidentiality

MedCost provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

MedCost participates in the Electronic Verification system (E-Verify) to electronically verify the work authorization of newly-hired employees. E-Verify is an internet-based program that compares information from an employee's Form I-9 to data contained in the federal records of the Social Security Administration and the Department of Homeland Security to confirm employment eligibility. MedCost does not use E-Verify to pre-screen job applicants.

Required profile