Process Improvement Professional 1 - Finance/Accounting

Profile

Description

The Process Improvement Professionals perform various levels of quality assurance reviews and audits for the Finance Department at Enclara (subsidiary of Humana). This includes initiating, researching, and analyzing various data points in disparate systems, especially those impacting revenue and cost. Systems utilized during review include inventory management, claim processing adjudication systems, CMS tools, and SQL Management Studio.

Responsibilities

The Process Improvement Professional 1 collects and analyzes process data to initiate and/or recommend business practices. In this role, work assignments are often mixed between routine monthly tasks to and ad hoc request of various complexities. While team approaches are often utilized during large or complex projects, most work is individual based. Consistent intellectual curiosity, learn/adaptability and communication within and outside the department are key. You will work closely with the Process Improvement Professional 2 and reports directly to the General Accounting Manager.

Key Responsibilities:

Perform billing QA/internal audit procedures using various internal systems including client specific reviews.

Review new and existing customer billing profiles, invoices, & set up to ensure compliance with contractual terms.

Routine reconciliations of dispenses to invoicing to ensure completeness and accuracy of customer invoicing.

Active participation in the due diligence during various merger and acquisition efforts. System integration review for acquisitions and intercompany operations.

Test data flows between various inventory, operating and billing systems. This includes, but is not limited to, testing of new inventory management systems and newly established connections to intercompany operations and system.

Complete third-party vendor audits to ensure billing accuracy according contractual agreements.

Analyze billing and invoice trends; effectively communicating areas of concerns and/or risk in a timely manner.

Actively monitor IT updates to proactively test updates that may impact Billing systems. This include reviews in test environments and in production upon release.

Audit to identify and optimize any operational gaps and inefficiencies. This includes reviewing SOPs, training documents, and daily operational activities that may drive increased cost/waste, reduce revenue, or encourage a poor customer experience.

Review and analyze rebates submission files and subsequent rebate receivable reconciliation.

Identify potential revenue generation and/or revenue risk for the company.

Perform various ad hoc revenue analyses and communicate results through impact analyses.

Ensure that external communications follow HIPAA.

Maintain a team approach within the Finance group and other functional areas and support a wide variety of ad hoc needs.

Performs other duties as assigned and/or needed.

Required Qualifications

Bachelor's degree

In-depth experience in Microsoft Excel including formulas, pivots, charts, graphs, etc

Comprehensive knowledge of Microsoft Office applications

Well-organized, thorough, detail-oriented individual with ability to analyze and reconcile data with accuracy.

Outstanding problem-solving skills and ability to apply the appropriate tools and level of analysis to specific situations.

Ability to communicate effectively both orally and in writing to diverse audiences.

Strong ability to adapt to a changing environment

Strong analytical and mathematical skills.

Ability to implement process resulting in satisfactory audit practices.

Strong interpersonal skills; ability to develop and maintain business relationships.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

Knowledge of Microsoft SQL

Knowledge of MS Dynamics Great Plains and/or Oracle

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com