Job Description

Responsibilities

Coordination of data from outside vendors and internal divisions to ensure complete and accurate ACA compliance, such as EDGE database support, RADV audit, Risk Adjustment and other programs. 

  • Coordinate cross-functional teams to design and implement financial controls that incorporate consideration of all relevant process and technology touch-points and data exchanges to identify and re-mediate risks to the accuracy of financial data and controls.
  • Perform analytics of member/claim data to support Risk Adjustment and maximise results.
  • Maintain accurate and concise documentation, developing SOPs for the department
  • Provide support to Lead Financial Auditor and advisor during the RADV audit by developing and maintaining reports, support the outreach to provider for medical record request.


Requirements

  • Bachelor’s degree and/or equivalent work experience in a related field demonstrating knowledge of finance, accounting, and/or compliance (CIA, CPA or CFSA a plus)
  • 5-7 years in Accounting, creating and/or conducting audits and corresponding plans
  • At least 3 years’ experience with actuarial, Healthcare and regulatory compliance
  • Strong/Advanced Microsoft Excel skills
  • Proven ability in planning and execution of assignments
  • Ability to conduct sensitive investigations and maintain confidentiality
  • Ability to build strong relationships with all internal and external customers
  • Ability to present findings clearly and efficiently

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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