Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Under the direction of the Supervisor, Finance Operations, The Finance Operations Analyst is responsible for the execution of multiple complex operational processes associated with Claims Disbursements, Provider Collections and Corporate Accounting Operations. The Analyst ensures timely and accurate completion of claims validation and release, provider refunds, Invoice processing, and payment reconciliations. The Analyst participates in key Finance Operations initiatives, including but not limited to operational improvements, new product development and implementation, new vendor partnership implementations and technological advancements. This position requires a strong business and technical skills with the ability to work across multiple systems/interfaces. This is a cross functional role that interacts with internal and external business partners, requiring strong communication skills.

Key Responsibilities/Duties – what you will be doing

FINANCE OPERATIONS ANALYST RESPONSIBILITIES:

Responsible for accurate and timely completion of production cycles and related processes within prescribed deadlines, including reconciliations, and control reporting.
Identify production issues and assist team members and management on resolution.
Responsible for completion of weekly and monthly production reporting, including validation and reporting issues or anomalies to senior team members for analysis and resolution
Develop and maintain collaborative working relationships with internal business partners
Assist with corporate projects and departmental initiates to ensure successful implementation and integration of all business processes and assist with other department projects as needed.
Update and maintain policies, procedures, and workflows.
Responsible for responding to internal and external audit requests
Provide superior customer service to internal and external customers
Other duties as assigned by Supervisor or Manager

OTHER RESPONSIBILITIES:

Perform operational activities associated with claims-related disbursements processes, weekly and monthly claims payment release, voids, invoice payment, and other financial disbursements
Work in coordination with other departments on the processing of provider refunds or payments, and the reconciliation and closing of those transactions from the financial perspective
Research transactions associated with claims, enrollments, cash/accounts receivable, and payments to facilitate correct transaction processing
Process transactions associated with unclaimed property, including tracking, organizing, and prioritizing the work
Assist with 1099 MISC/NEC/INT customer service inquires
Assist with reporting and reconciliations related to the operational activities listed above
Triages and follows up on weekly rejects related to claim payments
Manage the monthly supplier and invoice hold report and reconciliation process

Qualifications – what you need to perform the job

EDUCATION: (Minimum education & certifications required)

Bachelor’s degree in accounting or business administration required.

EXPERIENCE: (Years of experience)

Minimum one to three years of analytical work which demonstrates the abilities to perform in the position.
Accounting, finance, or banking experience is preferred, managed health care operations experience is a plus

SKILL REQUIREMENTS: (Include interpersonal skills)

Proven ability to operate in a fast-paced environment and have the flexibility to adapt to changing processes and timelines.
Ability to work independently in a highly organized and self-motivating manner.
Must be able to interpret complex business situations and understand the Financial Operations implication, and to work with multiple systems.
Must possess excellent critical thinking and problem-solving skills and demonstrated experience with analytical work.
Technical proficiency in Excel is required
Technical proficiency in database applications and Cognos reporting is preferred.
Professional attitude with good communication skills as this position frequently interacts with internal and external customers
This position must be able to work collaboratively with team members and interdepartmental coworkers.
This position frequently interacts with external customers
Excellent verbal and written communication skills are required.

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)

The Finance Operations Department is a fast-paced environment.
This position consistently is meeting multiple demands and deadlines.
Occasional work outside normal business hours may be required.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Harvard Pilgrim Health Care is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations always.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org