Position Summary 

Finance Specialist II responsibilities include but are not limited to, performing financial and accounting related activities, addressing financial issues and maintaining accurate financial data and reports. 

Duties and Responsibilities

· Analyze monthly capitation revenue and membership increases and decreases. 

· Analyze monthly MLR and provider utilization by specialty related entities. 

· Analyze monthly Humana center MLR. +

· Prepare monthly Financial Network Performance and Profitability Analysis.

· Analyze Network Fee Schedule and Provider Reimbursement Rates

· Update monthly Operating Expense Table for Provider Network Solutions and the TPA.

· Reconcile Capitation vs. Eligibility files for all Networks. 

· Monitor claims inventory and claims payout amounts compared to the budget and update dashboard on a weekly basis. 

· Prepare accounting journal entries to support the monthly financial activities by posting wire transfers, and bank fees, TPA fess and claims transfers in Great Plains accounting software. 

· Perform monthly Bank Reconciliation from Great Plains for all bank accounts pertaining to specialty related entities.  

· Upload and reconcile payments received from our fee for service business. 

· Prepare yearly 1099s for all contracted physicians/organization for all our networks.  

· Renewal of all annual insurance policies. 

· Assist with annual audit process.  

· Assist with Analysis Projects regarding current and new business. 

Knowledge

· Associate’s degree in accounting, Finance or relevant field.

· Knowledge of basic bookkeeping procedures.

· Familiarity with finance regulations.

Skills and Abilities

· Organization skills.

· Ability to handle sensitive, confidential information.

· Good math skills and the ability to spot numerical errors.

· Hands-on experience with MS Excel and accounting software (e.g., QuickBooks).