Associate Finanical Analyst - Billing Operations

• Full-time
• Department:
  Finance | Actuary | Underwriting
• Pay Grade: 18

Why Wellmark?

We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we've built our reputation on over 80 years' worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors our members. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!

Learn more about our unique benefit offerings here .

Want to know more? You can learn about life at Wellmark here .

Responsible for managing processes within Billing Operations to deliver accurate and timely accounts receivable and billing services across multiple market segments, including high-profile groups. This role oversees rate setup and configuration in Wellmark's billing systems, account and group setup, billing reconciliation, financial processing, and data maintenance across billing platforms. The position partners with internal business areas, members, and employer groups to resolve inquiries, clearly communicate billing processes, and provide a consistent service experience.

Additional responsibilities include supporting audits and regulatory compliance, producing accurate reports, representing the department on rating configuration initiatives, and contributing to process improvements and business continuity efforts.

Required:

• Bachelor’s degree in accounting, finance, business or related field, or direct and equivalent work experience.
• 2+ years demonstrated experience in benefit processing, funding arrangements, enrollment, quality or billing operations, or in underwriting.
• High-level understanding and knowledge of accounting concepts, billing and payment policies and procedures, departmental HIPAA guidelines, data structure and systems.
• High-level understanding of different financial arrangements for fully insured, self-funded, controlled self-funded, minimum premium, and maximum liability groups. Full understanding of stop loss contract administration including outside stop loss arrangements.
• Solid experience in MS Office Suite, specifically Microsoft Excel experience (including formulas, pivot tables, etc.). Experience in pulling reports from Business Objects; developing queries in the system to extract data.
• Demonstrated ability to use critical thinking skills, manage multiple processes, work under pressure to meet timelines and accuracy guidelines or initiatives, and take ownership
• Demonstrated strong interpersonal skills with the ability to build relationships of collaboration and trust.
• Ability to work with and actively protect confidential information and data.
• Demonstrated ability to identify issues or inconsistencies and recommend alternative solutions.
• Ability to guide and train others on rating concepts and processes.

Preferred:

• Wellmark experience with working knowledge of Facets.
• Need to have a natural propensity for quality and research. Ability to educate and influence/be diplomatic.

Job Responsibilities

a. Review and ensure accuracy of billings for claims and administrative fees for self-funded, minimum premium and maximum liability groups using a high level of understanding and knowledge of funding arrangements and mathematical skills. Includes tracking and interpreting all new and renewal group paperwork to ensure accuracy and completeness.

b. Accountable for the review of weekly and monthly invoice reporting packages with a demonstrated ability to ensure accuracy and timeliness of customer bills. Includes completion of manual custom special reporting and reconciliations as needed for high profile groups which involves a thorough understanding of available billing reports and report assignments.

c. Responsible for bill generation and the utilization of multiple systems within necessary time frames to ensure proper completion and sufficient time for quality assurance reviews.

Time frames are dependent based on market segment and system used which require comprehensive knowledge of time frames specific to each system.

d. Accountable for reconciliation of complex premium payments to billings for fully insured individuals and groups to ensure accurate billings, balances and payments applied correctly.

Billing knowledge is critical as each reconciliation is different based on what the group paid vs. the billed…