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Sr. Financial Analyst

Medical Associates, Dubuque, IA

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We are recruiting for a full-time Senior Financial Analyst to work in the Medical Associates Health Plans Finance Department. Health insurance knowledge is helpful but not required. Candidates must possess a high level of Excel proficiency. Role: Evaluate and determine pricing for all products and services and complete all related regulatory filings. Create and analyze reports needed for the Health Plan and Clinic decision making. Create and review internal audits on Medicare process. Assist in the preparation of the claims portion of the Cost Report. Essential Functions & Responsibilities: Develop reporting necessary for evaluation of results, in conjunction with MIS, claims and accounting personnel. Create and manage related ad hoc reports/reporting. Assist in preparation of the claims portion of the Cost Report and project work to assist in senior team’s decision making. Review prospective rate proposals and renewals on a regular basis and make recommendations to the Manager of Underwriting/Financial Analysis. Assist in the annual pricing calculation and filing requirements. Ensure compliance with the Affordable Care Act regulations including preparing and maintaining rate filings, Medical Loss Ratio submission, audit of submitted date for Risk Adjustment Scoring, and other State and Federal requirements. Develop and maintain internal audits, including Medicare audit of processes and identify areas of Medicare risk. Continuously research audit requirements to ensure compliance, review performed audits, meet with departments to resolve issues, and present findings at Quarterly Compliance Meeting. Analyze actual claim results versus medical budgets. Investigate variances. Consult with health services on results and corrective action possible or necessary. Assist in preparation of annual budget. Prepare for year-end financial and compliance audits by contracted auditors and state regulators. Complete all other assigned projects and duties as assigned.

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Job Details

Req Num 17-0067
ID 384197
Dubuque, IA
Positions 1
Full Time
Pay --
Banking/Mortgage/Financial Services
Health Care

Preferred Candidates

Years of Experience --
Education Bachelors

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