Reinsurance Rec Analyst

The Reinsurance Rec Analyst is responsible for analyzing, compiling and reconciling claims data in accordance with the guidelines and contract specifications set by our carriers.

Compile data related to claims to determine reinsurance eligibility. Review previously billed and denied data to correct errors and rebill to maximize collections. Apply cash to outstanding receivables when applicable. Work with claims to determine eligibility, incorrect processing and correction strategy. Prepare ad hoc reports Perform balance sheet reconciliation Update general ledger with appropriate entries

Minimum Qualifications:

  • Prior experience working with claims to determine eligibility, incorrect processing and correction strategies

  • Prior experience with MS Excel functions that include working with large data sets, creating standardized reports (across multiple spreadsheets), utilizing vLookups; creating, using and interpreting pivot tables, filtering and formatting.

  • Ability to effectively communicate with all levels of the organization, including technical staff, internal non-technical staff, testing teams, and business stakeholders.

  • Ability to multi-task between meeting daily deliverables; as well as project enhancement initiatives

  • Associates Degree from an accredited institution

Preferred Qualifications:

  • Experience with Managed Healthcare Systems (MHS)

  • Any basic, programming or coding experience with SAS or SQL

  • Knowledge of medical billing and coding

  • Experience in in stop loss or reinsurance analysis

  • Bachelors Degree from an accredited institution

Compliance & Regulatory Responsibilities: N/A

License/Certification: N/A

  • Please note: Since we care so greatly about our employees' and members' wellbeing, Healthfirst is moving to an environment where our employees are fully vaccinated against COVID-19. As a prospective new team member, you must be fully vaccinated with a CDC/FDA approved COVID-19 shot(s) to work in our offices. If you are selected to interview for this role, we will explain our vaccination policy in further detail and ensure you are comfortable moving forward with this company policy.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

All hiring and recruitment at Healthfirst is transacted with a valid @healthfirst.org email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Minimum Qualifications:

  • Prior experience working with claims to determine eligibility, incorrect processing and correction strategies

  • Prior experience with MS Excel functions that include working with large data sets, creating standardized reports (across multiple spreadsheets), utilizing vLookups; creating, using and interpreting pivot tables, filtering and formatting.

  • Ability to effectively communicate with all levels of the organization, including technical staff, internal non-technical staff, testing teams, and business stakeholders.

  • Ability to multi-task between meeting daily deliverables; as well as project enhancement initiatives

  • Associates Degree from an accredited institution

Preferred Qualifications:

  • Experience with Managed Healthcare Systems (MHS)

  • Any basic, programming or coding experience with SAS or SQL

  • Knowledge of medical billing and coding

  • Experience in in stop loss or reinsurance analysis

  • Bachelors Degree from an accredited institution

Compliance & Regulatory Responsibilities: N/A

License/Certification: N/A

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Posted
06/21/2022
Salary Range
$87,000.00 - $107,000.00
per Year
Salary range estimated by
salary estimation provided by zippia
Location
New York, NY, 10261, US