Revenue Analyst

$53,500 - $118,100/Yr

Health Care Service Corporation - Chicago, IL

Full-time - Mid Level

Hybrid - Chicago, IL

Insurance Carriers and Related Activities

About the position

This position at HCSC is focused on data management, specifically related to Medicaid member premiums. The role involves the submission and reconciliation of discrepancies, as well as analysis and reporting for Medicaid member premium data sourced from State Government. The data managed will be utilized by the Medicare member reconciliation manager and various levels within the organization. Key responsibilities include maintaining a database of member variable data, creating compliant reports, and ensuring data quality in submissions to CMS. The position also requires collaboration with internal and external stakeholders to resolve discrepancies related to CMS premium reconciliation management.

Responsibilities

• Manage data related to Medicaid member premiums and ensure accurate reporting.
• Reconcile discrepancies in member data from Medicaid and CMS reports.
• Create and submit compliant reports to CMS regarding member-related data.
• Maintain the database of all member variable data and ensure data quality.
• Facilitate coordination among internal and external stakeholders to resolve discrepancies.
• Compute member premiums from CMS and create necessary reports and dashboards.
• Import data from CMS, plan, and vendor sources.

Requirements

• Bachelor's degree in Accounting, Finance, or related field.
• 4 years of experience in health care, managed care, health insurance, or consulting.
• Experience with Medicare Advantage payment methodology and CMS Payments.
• Knowledge of Medicaid member demographic status, Late Enrollment Penalty, and Medicare as Secondary Payer.
• Proficiency in SQL, SAS, and MS Excel for data manipulation and report development.
• Strong analytical, verbal, and written communication skills.
• Ability to manage time effectively and multitask under multiple deadlines.

Nice-to-haves

• Master's Degree or certification in Accounting, Finance, or related field.
• Knowledge and experience with Medicaid Member and Enrollment processes.
• Experience with Power BI.

Benefits

• Professional development opportunities
• Inclusive workplace culture
• Employee referral program
• Health insurance coverage
• Flexible work arrangements (hybrid role)