Finance Specialist II

Description

Finance Specialist II responsibilities include but are not limited to, performing financial and accounting related activities, addressing financial issues and maintaining accurate financial data and reports.

• Analyze monthly capitation revenue and membership increases and decreases.
• Analyze monthly MLR and provider utilization by specialty related entities.
• Analyze monthly Humana center MLR.
• Prepare monthly Financial Network Performance and Profitability Analysis.
• Analyze Network Fee Schedule and Provider Reimbursement Rates.
• Update monthly Operating Expense Table for Provider Network Solutions and the TPA.
• Reconcile Capitation vs. Eligibility files for all Networks.
• Monitor claims inventory and claims payout amounts compared to the budget and update dashboard on a weekly basis.
• Prepare accounting journal entries to support the monthly financial activities by posting wire transfers, and bank fees, TPA fess and claims transfers in Great Plains accounting software.
• Perform monthly Bank Reconciliation from Great Plains for all bank accounts pertaining to specialty related entities.
• Upload and reconcile payments received from our fee for service business.
• Prepare yearly 1099s for all contracted physicians/organization for all our networks.
• Renewal of all annual insurance policies.
• Assist with annual audit process.
• Assist with Analysis Projects regarding current and new business.

• Associate’s degree in accounting, Finance or relevant field.
• Knowledge of basic bookkeeping procedures.
• Familiarity with finance regulations.

• Organization skills.
• Ability to handle sensitive, confidential information.
• Good math skills and the ability to spot numerical errors.
• Hands‑on experience with MS Excel and accounting software (e.g., Quick Books).