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J211092

Manager ASO Billing & Settlements

Highmark Inc.

  • Company Highmark
  • Home, PA
  • Finance
  • Full time
  • Day (United States of America)

Company :

Highmark Inc.

Job Description : 

GENERAL PURPOSE:  

This manager role is responsible for one or more of the following functions/responsibilities in support for all ASO billing and Accounts Receivable Management for medical/dental claims activities, buy-up, shared savings, drug, Spending Account, ERISA reporting, client reconciliation/Settlements of Non and Semi-Risk business and creation of customized customer ad-hoc reporting.  This job manages a team responsible for the review of reconciliations, analysis, and oversight of the maintenance of related financial records.   Proactively adapt to business and market changes by developing and managing activities required to ensure accurate, timely and efficient completion of financial operations. 
This position is responsible for managing successful outcomes on projects impacting assigned processes related to enhancements, expanded capabilities, system or business migrations, company integrations, new product offerings etc. that may span outside of the finance department.  Collaborates on strategic and tactical initiatives to ensure all financial impacts are evaluated and incorporated into business and technical solutions.  Plans, manages, and oversees the implementation of strategic business and functional infrastructure of the underlying systems that support subsidiaries, affiliates, and market segments, that rely on the finance business platforms.  Identify business opportunities, short- and long-term solutions, create high level vision requirements and define expected outcomes, review and approve technical requirements, test cases, and production release management to ensure quality outcomes.
 


ESSENTIAL RESPONSIBILITIES:

  • Manage the claims invoicing, A/R, payment reconciliation, and maintenance of financial reporting data and corporate A/R data subsequently fed to the General Ledger.  Develop and maintain consistent application of input and output balancing controls
  • Ensure Highmark customers understand the financial impact of various billing methods and how they relate to the customer’s overall financial objectives.  
  • Synchronize data between ICIS and CBS to ensure accurate management service revenue (MSR).  Works with sales and/or Underwriting & Rating do resolve discrepancies.  Meet with support and ISG staff to ensure system related issues are prioritized and completed according to production and business needs.
  • Track and escalate non-paying customer information to senior level sales management to ensure adequate action is taken to mitigate Highmark’s risk on what is identified as a “non-risk” population.
  • Respond to various requests from external and internal auditors regarding billing and accounts receivable activities, ensuring that information provided to the auditors is reviewed for completeness and accuracy.  
  • Create a work environment that recognizes, rewards, and motivates employees to continuously improve Highmark’s business, adding greater value to the products and services supplied to Highmark customers.  Facilitate meetings with direct reports to ensure all department objectives and goals are being monitored and requirements are being communicated on a consistent and timely basis.  
  • Development of policies, procedures, and controls that support compliance with internal and external audit requirements, including government regulations, SAS and SOX compliance, and HIPAA guidelines.  Perform periodic training sessions with Sales and Account Administration personnel to ensure a sufficient working knowledge of the Claims & Wire Billing process is present.
  • Other duties as assigned or requested.


QUALIFICATIONS:
 

Minimum

  • High School Diploma
  • 4 years experience in accounting, billing and/or accounts receivable management.      

Preferred

  • Bachelors degree in Accounting or Finance
  • 5 years management experience in Accounting, Billing and/or Accounts Receivable.

SKILLS

  • Understanding of health insurance activities including but not limited to billing, financial and audit processes.

Preferred

  • Experience in health insurance industry3 years
  • Experience managing staff and/or projects of varying size and complexity7 years
  • CPA 
  • Expert knowledge of Highmark’s operational and financial systems and reporting processes  

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.


As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Referral Level Payout Level 2

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice


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