Jai Medical Systems Managed Care Organization, Inc. was founded in 1997 and serves a diverse population of children and adults throughout the State of Maryland.
Since our founding, Jai Medical Systems' mission has been to provide high quality healthcare benefits and services to the people of Maryland. We continue this tradition of quality and excellence by working with our members to help identify their healthcare needs, while remaining an active and positive presence within our communities.
Throughout our history of service, Jai Medical Systems has been consistently ranked by the State of Maryland as one of the highest rated Managed Care Organizations for quality. Jai Medical Systems' commitment to our members and high quality healthcare is demonstrated by our performance in health insurance quality measures, such as HEDIS ®.
Job Summary:
We are currently seeking a hardworking, experienced, and reliable individual for a Financial Analyst position.
Financial Analyst responsibilities will include:
- Assist with the preparation of quarterly and annual financial statements and periodic cost reports.
- Analyze, research, and adjudicate pended medical claims.
- Review and analyze claims data, professional and institutional medical claims, medical records, and billing and payment information to determine if charges and reimbursement are supported in accordance with federal, state, and corporate guidelines.
- Complete monthly reporting on historical claims payment information.
- Manage the organization and submission of document requests for external auditors.
- Perform ad-hoc report requests and analyses as requested by management.
- Maintain confidentiality of sensitive financial data.
- Perform documentation and coding audits, reviewing medical claims, records, and charges to ensure compliance with CPT coding and ICD10 coding standards.
- Conduct analysis of findings to identify trends/problems in billing and documentation.
- Draft written reports that detail audit findings and recommendations to senior leadership, Department management/personnel, and/or other related business partners.
- Analyze current payment policies and make recommendations to improve program integrity and organizational processes.
- Additional duties as assigned.
Financial Analyst minimum requirements:
- College degree in a finance or accounting related field required (or equivalent combination of related education and experience).
- 2-5 years' experience, preferred.
- Related experience with medical claims, reviews such as utilization management, quality assurance, charge capture, coding, billing and medical necessity to facilitate correct claims submission to federal and state payers is preferred.
- Experience in Microsoft Office, Excel, and Access.
- Knowledge of financial and healthcare principles, preferred.
- Demonstrate reliability, confidentiality, and professionalism.
- Ability to solve problems.
- Able to work well independently and maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Full-time required in-office hours Monday-Friday 9am-6pm.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
Application Question(s):
- Are you available to work required fully in-office hours Monday-Friday 9am-6pm (1 hour lunch)?
Education:
Work Location: In person