Financial Analyst II - Covered California

Company: Inland Empire Health Plan
Location: Fontana
Posted on: April 18, 2025

Job Description:

What you can expect!

If you would like to know a bit more about this opportunity, or are considering applying, then please read the following job information.

Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!

Under leadership of the Supervisor of Finance Analytics - Commercial Finance, the Financial Analyst II - Commercial Finance will complete a variety of specialized duties related to financial reconciliation of premium invoicing and payments from various sources, monitoring of BPO vendor, collaborating with cross-departmental teams to resolve payment issues, and ad-hoc analysis as it relates to commercial products. This role will work with large data sets and develop moderate SQL queries.

Key Responsibilities:

1. Monitor and respond to inquiries, both internally and externally, regarding premium invoicing.
2. Analyze over- or under-premium payments and submit findings for leadership review.
3. Perform research into member premium issues and/discrepancies and provides recommendations on solutions.
4. Program simple to moderate SQL queries to perform reconciliation of various revenue streams (i.e.: Member payments, APTC payments, state credit/subsidies) to ensure Member accounts are accurate.
5. Resolve payment disputes received from the merchant services vendor and lockbox decisioning items received from bank lockbox to ensure funds are accurately applied to member accounts in a timely manner.
6. Work with print vendor to create/update premium billing notifications and member notices as it pertains to premium payments, as required by regulatory guidelines.
7. Coordinate with BPO vendor for programming modifications and/or other business needs.
8. Perform detailed analysis of refund requests and/or overpayments and process member refunds.
9. Perform verification of internal and external broker commission payments to ensure accuracy of payments.
10. Prepare month end reports and/or journal entries for monthly financial reporting and management reporting requirements.
11. Perform accurate interpretation of regulatory requirements as it pertains to premium billing activities, member notices as it relates to member premiums, and revenue reconciliation requirements.
12. Act as a trusted resource for the organization and consistently demonstrates IEHP organizational values while building and maintaining strong internal relationships.
13. Demonstrate a commitment to incorporate LEAN principles into daily work.
14. Any other duties as required ensuring Health Plan operations are successful.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

This is a full remote position. California residency required.
CalPERS retirement
457(b) option with a contribution match
Generous paid time off- vacation, holidays, sick
State of the art fitness center on-site
Medical Insurance with Dental and Vision
Paid life insurance for employees with additional options
Short-term, and long-term disability options
Pet care insurance
Flexible Spending Account - Health Care/Childcare
Wellness programs that promote a healthy work-life balance
Career advancement opportunities and professional development
Competitive salary with annual merit increase
Team bonus opportunities

Education & Experience

Minimum three (3) years of premium billing, premium and membership reconciliation, and/or premium reporting experience. Experience working with other finance teams to support monthly financial reporting. Experience working with large data sets and developing moderate SQL queries. Managed care experience related to commercial products required.
Bachelor's degree in Finance, Business Administration, Economics, Health Care Administration, Accounting, or other related field from an accredited institution required.

Key Qualifications

Strong knowledge and practical application of premium billing practices in the healthcare industry.
Working knowledge of generally accepted accounting principles (GAAP) and practical application of general accounting theory.
Must have SQL Server query development and writing skills.
Intermediate skills in utilizing Excel and Word.
Strong communication abilities (both written and verbal) and problem-solving skills.
Strong critical thinking, analytical, problem solving, and prioritizing skills.
Strong initiative to meet established deadlines.
High level of attention to detail is required.
Be able to communicate effectively at all organizational levels both orally and written.

Start your journey towards a thriving future with IEHP and apply TODAY!

Pay: $80,059.20 - $106,059.20 per year

Work Location: In person

Keywords: Inland Empire Health Plan, Spring Valley , Financial Analyst II - Covered California, Professions , Fontana, Nevada