Centene - Pittsburgh, PA
posted about 2 months ago
As a Revenue Reconciliation Analyst at Centene, you will play a crucial role in reconciling memberships and premiums between the Health Plan and government partners. This position is essential for ensuring that the organization receives the appropriate premium for the services provided. You will be responsible for conducting timely reporting and offering process improvement recommendations to enhance the reconciliation processes for Community Health Choices. Your collaboration with service partners within the Corporate and Regional sites will be vital, as you will develop business contacts to facilitate effective communication and problem-solving. In this role, you will engage directly with members via phone to assist them with their Redetermination process. Providing high-quality customer care is paramount, and you will support members in connecting with County Assistance Offices if they require additional help completing their renewal packets. Your ability to multi-task using various internal and external applications will be essential as you identify and research monthly premium discrepancies between expected premiums and actual payments. You will also be responsible for downloading reconciliation results into management reporting tools, tracking, researching, and resolving identified discrepancies. Engaging in membership eligibility research will require critical thinking skills and the ability to analyze and resolve payment discrepancies effectively. You will quantify and document the revenue implications of these discrepancies and provide management with monthly established Financial Indicators. Additionally, you will contribute to the development and documentation of reconciliation workflows and educational tools to facilitate cross-training and internal controls. Other duties may be assigned as necessary.