Senior Insurance Accountant-Peak Health

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor's degree in accounting or related field.

EXPERIENCE:

1. Five years' of insurance accounting experience.

2. Five years' Health Insurance Accounting experience required, preferably with experience directly in Medicare Advantage or Medicaid.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. Statutory regulatory accounting experience highly preferred.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Aid in the planning and build out of statutory quarterly and annual financial statements. This may include the coordination and preparation of all footnote disclosures, management discussion and analysis, and internal controls.

2. Tracking, managing, and submitting all U.S. (State based and NAIC) Finance related regulatory fees and filings.

3. Making, recording, and reconciling government business capitated payments.

4. Prepare and file State-Specific Finance Forms and supplements including various schedules.

5. Monitor due dates and ensure timely compliance with state filing deadlines pertaining to Finance filings.

6. Track and submit renewals, fees, and changes in company information to each state regulator.

7. Coordinate with regulatory reporting function to ensure Finance accountabilities align with overall regulatory filing calendar.

8. Corresponding with regulators proactively as needed.

9. Partner with applicable parties to ensure proper support of general ledger data/applications supporting external statutory accounting and financial reporting.

10. Reconcile and explain GAAP vs STAT differences, particularly in areas like loss reserves and premium recognition.

11. Manage risk-based capital (RBC) calculations, asset admissibility, and premium deficiency testing.

12. Oversee reinsurance accounting, including ceded/assumed premiums and recoverables.

13. Support loss reserve development, including IBNR estimation and actuarial collaboration.

14. Respond to state regulatory inquiries to support routine financial inquires.

15. Analyze underwriting results and trends impacting statutory profitability.

16. Reconcile cash accounts associated with claim disbursements associated with government products.

17. Accountable for ensuring governmental products premium billing process is accurate.

18. Reconciling Medicare Advantage Prescription Drug payable and receivables, including cost sharing programs and rebates.

19. Assist in accounting and treasury management of the investment portfolio.

20. Coordinate with the tax department in accounting for and transacting various regulatory taxes.

21. Supporting the accounting classification of expenses between Medical and Administrative.

22. Supporting the development of regulatory rate setting, by assisting in the provision of administrative expense actual and projections.

23. Support the filing of various regulatory financial schedules and attestations, including but not limited to MLR filings, Medicare DIR filings, etc.

24. Coordinate with the Actuarial and Operational Analytic functions to maintain risk adjustment accruals.

25. Develop strong relationship with Department managers to help coordinate and monitor financial controls over the organization's cost centers according to approved budget guidelines.

26. Coordinate accounting and financial processes to maximize efficiency in the daily accounting operations. Ensure that internal control measures are being followed.

27. Maintain general ledgers to complete and submit accurate financial data during month-end process according to predetermined deadlines.

28. Lead and coordinate month end variance analysis.

29. Oversee and review month end general ledger reconciliations.

30. Directly supervise the work and development of assigned Accounting Department staff.

31. Coordinate other staff duties to accomplish department goals and objectives. Delegate projects/duties, as necessary.

32. Develop and submit analytical financial data as needed by department director/manager.

33. Assist in completing and compiling financial support documentation for budget and external audit purposes.

34. Assist in coordination of the budget and external audit review.

35. Train new personnel and monitor their progress.

36. Participate in educational opportunities as provided by Peak Health to enhance skill related abilities.

37. Complete other duties as assigned by manager.

38. Support performance improvement and quality assurance initiatives.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

1. Employee may need to sit during extended periods of time.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

1. The employee will be working in an office environment.

2. Must be able to use a computer, answer the telephone, and use other office equipment (fax, copier, printer).

SKILLS & ABILITIES:

1. Ability to work with computer databases and spreadsheet software.

2. Excellent organizational skills, attention to detail, accuracy, time management, and deadline adherence.

3. Strong verbal and written communication skills; analytical and interpretive skills.

Additional Job Description:

Scheduled Weekly Hours:

Shift:

Exempt/Non-Exempt:

Company:

Cost Center:

Address:

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.