Job Summary

Performs analytics, reporting, Billing/Enrollment Operations support, Finance Operations support, system configuration, processing of TPA capitation payments, automation requests and ad hoc requests.

Job Duties

Coordinates and verifies the accuracy of premium billing and capitation payments.
Develops ad hoc reports as required in billing and capitation system for financial reporting.
Provides direct support to the configuration, maintenance and operation of the billing and capitation system, including the areas of billing, accounts receivable, capitation payable, claims payable, weekly check processing, new product development, and the third-party administration function.
Assists with reviewing and interpreting regulatory requirements regarding state and federal laws pertaining to premium billing and vendor capitation.
Creates auditing and reporting tools to comply with such requirements.
Provides support and direction toward the development of solutions to operational problem areas as well as compliance with governmental regulations and changes.
Assists in implementation of billing and capitation system upgrades.
Assists with disaster recovery testing.
Receives, analyzes and recommends appropriate action on user requests for services, including design and preparation of reports or automation of processes choosing the most appropriate tools to provide efficient and accurate results.
Provides functional and technical expertise in assigned areas of financial systems and business operations.
Audits financial data and configuration plans prepared by other Finance personnel.
Coordinates requests for automation by other staff members.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years).

Position Details

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 4 years-Relevant experience* (Required)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

Geisinger

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