Claims Overpayment Analyst - Financial Oper Analyst Ld - 96692

Company Name:
Amerigroup , a proud member of the Anthem, Inc. family of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
Claims Overpayment Analyst - Financial Oper Analyst Lead - 95448
Financial Operations Analyst Lead analyzes data and provides new processes, system enhancements and technical solutions to complex business issues. Leads and coaches staff. Manages workflow and oversees day-to-day department responsibilities. May conduct operational meetings with staff. Assists management in establishing work goals. Prepares management reports and may do budget variance.
Primary duties may include, but are not limited to:
Develops and executes complex data analysis.
Develops strategic report applications from Finance systems.
Writes queries and macros to enhance access databases and builds new databases in support of accurate balance sheet/P&L reporting.
Provides decision support and procedural input to ensure that processing efficiency does not compromise internal control mechanisms.
Interfaces with IT as needed and documents and tracks any needed system enhancements with IT management.
Documents and responds to any external audit requests.
Assists in the implementation of software releases within the Finance organization.
Ensures proper conversion or shutdown of legacy systems by developing and documenting enterprise solutions for successful transition to core processing systems.
Has technical and operational expertise.
Can commit department to deliverables on own initiative.
Uses discretion in making independent decisions.
Creates and develops partnerships with other departments including Health Plan Management, Claims, Customer Service, Provider Services Organization
Uses project management methodologies and experience to lead discussions with internal Corporate and Health Plan partners on complex issue tracking and resolution
Requires a BS/BA in accounting or finance; 5 years experience in a finance/health insurance field capacity; prior experience with relational databases and mainframe and client server report writers; project management experience; or any combination of education and experience, which would provide an equivalent background.
MBA, CPA, CMA, CFA or applicable professional designation preferred.
Medicaid/Medicare claims processing experience preferred
Data analysis to include root cause analysis preferred
Experience with FACETS preferred
Experience reviewing provider contracts for special handling and processing instructions, exceptions and single case agreements in order to ensure accurate claims processing and payment preferred
Proficiency in Microsoft Excel and Access preferred
/Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us / /./
/EOE. M/F/Disability/Veteran./
Job Accounting/Finance/Auditing
Title: Claims Overpayment Analyst - Financial Oper Analyst Ld - 96692
Location: AZ-Scottsdate
Requisition ID: 96692

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