Quality Control Business Analyst
$44,983–$71,973 year
On-siteSpringfield, Oregon, United States
Job Summary
Audit enrollment and billing transactions across Operations, documenting findings and preparing reports for management. Perform monthly accounts receivable reconciliations and resolve discrepancies in collaboration with CMS and State Exchanges. Support Membership Representatives in resolving group account discrepancies and validate ACH Debit files prior to bank submission. Partner with IT and Facets Business Support to test configuration updates, maintain departmental procedures, and develop ad hoc reports. Monitor pending payment accounts and assist with TPA spreadsheet setup to ensure data integrity and operational efficiency.
Required Qualifications
- Minimum of 1 year of Enrollment and Billing experience
- business analysis experience
- Advanced level experience using Excel
- creating spreadsheets
- using formulas
- pivot tables
- performing data comparisons
- Strong research experience
- troubleshooting experience
- Ability to gain understanding of PacificSource products
- plan designs
- group contracts
- eligibility guidelines
- billing functions
- accounts receivable
- health insurance terminology
- knowledge of the Eligibility and Billing Analyst position
- Membership Representative I & II positions
- Ability to work independently
- Strong keyboarding skills
- 10-key skills
- Ability to read and comprehend both written and spoken English
- Ability to communicate clearly and effectively
- Travel is required approximately 5% of the time
Desired Qualifications
- Accounting experience
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