Financial Transactions Specialist

2 days ago

Cebu City, Central Visayas, Philippines beBeeAccounting Full time ₱900,000 - ₱1,200,000
Accounting Analyst

We are seeking a detail-oriented Accounting Analyst to join our team.

Job Description

The successful candidate will be responsible for ensuring the timely and accurate resolution of discrepancies in Enrollment, Billing, and Reconciliation processes. This includes reviewing documentation, working items in queues, correcting errors, identifying trends, and documenting resolutions.

Responsibilities
  • Enrollment Processing
    • Process queue items, inter-departmental, and customer requests timely and accurately.
    • Review incomplete and pending enrollment applications and disenrollment forms for correction and submission to CMS.
    • Review and complete Late Enrollment Penalty (LEP) Attestations.
    • Review and complete Other Health Insurance (OHI) verification and error correction.
    • Review and create retro processing packets to be submitted to the CMS Retro Processing Contractor (RPC).
  • Billing Processing
    • Identify and post customer payments not automatically applied by the appropriate system.
    • Respond to billing-related correspondence.
    • Review and investigate returned checks, rejected ACH, and credit card transactions.
    • Process requests for automated premium payment via credit card or ACH withdrawal.
    • Review and approve/deny customer requests for premium refunds in accordance with established policies.
    • Monthly State Pharmaceutical Assistance Programs reconciliation.
  • Reconciliation Processing
    • Researching and correcting errors, discrepancies, and rejected transactions.
    • Monthly review and preparation of the CMS Enrollment Data Validation file and submissions.
  • All Functions
    • Working understanding of CMS guidance.
    • Conform with and abide by all regulations, policies, work procedures, and instructions.
    • Meet CMS guidelines and client SLA requirements through proper handling of transactions.
    • Perform outbound calls to customers or other entities as permitted to complete processing of enrollment, disenrollment, billing, and/or reconciliation transactions.
    • Make appropriate system corrections and escalate transactions that are unable to be corrected.
    • Prepare reports as requested by management.
    • Perform other duties and responsibilities as required.
Required Skills and Qualifications
  • High school diploma required; Associates Degree or higher preferred.
  • Minimum 2 years Health Plan Operations experience including Customer Service, Enrollment, and/or Claims processing.
  • Excellent analytical, decision-making, problem-solving, team, and time management skills.
  • Excellent oral and written communication skills.
  • Display positive demeanor, technical accuracy, and conformity to company policies.
  • Ensure HIPAA regulations are maintained within the immediate environment.
  • Communicate with coworkers, management, staff, customers, and others in a courteous and professional manner.
  • Knowledge of customer service best practices and principles.
  • Excellent data entry and typing skills; superior listening, verbal, and written communication skills.
  • Ability to handle stressful situations appropriately, while demonstrating empathy.
  • Resourceful, great at solving unstructured problems with little to no supervision in a fast-paced, high-stakes environment.
  • Team player with ability to collaborate with peers and managers; strong interpersonal skills and ability to build relationships.
Benefits

This role offers an opportunity to work in a dynamic environment and contribute to the success of the organization.

Others

Referrals increase chances of interviewing.

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