Your Role
The Self-Funded Finance team who handles the claims billing for all Self-Funded groups. The Financial Analyst, Experienced will report to the Self-Funded Finance Manager. In this role you will be Assisting with Group set ups from implementation to go live. Assist with ad-hoc reporting and various Self-Funded projects. Assist with department audits, month end reporting, and other various tasks.
Your Work
In this role, you will:
- Summarize detailed revenue/expense data and compare summarized claim data against fee schedules and contracts
- Produce contract performance reports, modeling of reimbursement rates, evaluation of financial contract modifications and compiling and monitoring key managed care statistics
- Collect and evaluate data, develop and maintain financial models, analyze results and conduct scenario analyses to forecast balance sheet, cash flow and regulatory capital
- Follow and conduct audit processes and review internal controls to ensure financial transactions are accurate, timely and comply with accounting standards, principles and company policy
- Provide policy guidance and interpretation to ensure financial records are consistent and comply with company policies and GAAP
- Analyze and audit weekly client invoices
- Manage set ups, active accounts, and termination for assigned clients
- Perform weekly and monthly reconciliation of banking, and claims activity
- Maintain and create department desk level procedures
- Partner with IT to resolve systematical issues
Your Knowledge and Experience
- Requires a bachelor's degree or equivalent experience
- Requires at least 5 years of prior relevant experience
- Facets claims system experience desired
- Claims knowledge desired
Pay Range: The pay range for this role is $71,280.00 to $99,770.00 for California.
Note: Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.