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Centene Corporation Senior Revenue Reconciliation Analyst in Pittsburgh, Pennsylvania

Position Purpose:

  • Position acts as a subject matter expert who will conduct outreach to County Assistance Offices (CAOs), nursing facilities, and service coordination entities to ensure correction of membership alignment in rate cells

  • Ensures timely and accurate reporting, process improvement and the ability to work collaboratively on the outreach to the above external partners in membership correction

  • Ownership for all aspects of the reconciliation process and the timely resolution for all outstanding discrepancies will fall under this position.

  • Works very closely with the Markets, Actuaries, Accounting, Enrollment, and IT partners within the Corporate/Regional sites and develop business contacts as deemed appropriate.

  • Reviews work done by other team members, assists with coaching and training other associates and provides direct support to the manager position.

  • Multi-tasks using multiple internal and external applications to identify and research monthly premium discrepancies between expected premium and actual payments, with minimal supervision.

  • Downloads reconciliation results into management reporting tools and performs the tracking, research and resolution of identified discrepancies.

  • Engages in membership eligibility research, requiring critical thinking skills and the ability to analyze and resolve payment discrepancies, to maximize the collection of accurate revenue.

  • Reports revenue and other financial data to the accounting department for monthly close activities. Provides Management with monthly established Financial Indicators.

  • Quantifies and documents revenue implications of payment discrepancies.

  • Prepares detail and summary level reports including written interpretation of analytic results.

  • Contributes to the development and documentation of reconciliation workflows and educational tools used to facilitate cross-training and internal controls. Provides review/coaching/training functions as needed for other associates.

  • Develops relationships with key members of other departments to communicate errors/issues in a timely manner.

  • Responsible for teaming with the business units to identify trend outliers and performs the work necessary to facilitate discussion and possible solutions.

  • Provides independent appraisals, analysis, observations and communicates issues clearly and confidently with management and other departments.

  • Provides reporting and ad hoc query analysis. Makes recommendations for reporting, process or operational improvements and drives for implementation.

  • Assists with design/requirements and performs testing on new releases of internal applications.

  • Collects required data for any internal or external audit requests.

  • Assists management on team decisions such as work load distribution, timing of specific processes, and associate development suggestions.

  • Performs other duties as assigned.

Education/Experience:

Required-High School or GED

Preferred -Bachelor's Degree in a related field may substitute for 2 years’ experience in any combination of Reconciliation, Auditing, Accounting or Analytics

Required 3+ years of experience in any combination of Reconciliation, Auditing, Accounting, or Analytics

Preferred 2+ years of experience in government payer systems

Preferred 1+ year of experience in Health insurance, Xcelys and in government program regulations

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

TITLE: Senior Revenue Reconciliation Analyst

LOCATION: Pittsburgh, Pennsylvania

REQNUMBER: 1214659

COMPANY: Finance & Actuarial

POSITION TYPE: Both

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