Benefits Operations Analyst in Alpharetta, GA at APEX Systems

Date Posted: 3/1/2018

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Job Description

Job #:  826174

Apex Systems, the nation’s 2nd largest Information Technology staffing firm, has an opportunity for a Benefits Analyst to work for one of our clients in Miami, FL. This is a 6 month contract 

If interested in this position send a resume to Samantha Kidby-

Benefits ?Analyst Job Description

The Benefits Billing Recon and Eligibility team is responsible for a number of operational tasks.  The department’s responsibilities include client billing, carrier payments and the associated reconciliation and adjustment processes, equaling $3 billion per year.  In addition to these tasks, the team serves as the first line of communication for client groups carrier partners, the internal service teams, and the accounting department.  Another main area of focus is the transferring of accurate and timely eligibility information between client systems and our carrier partner systems.  Eligibility related responsibilities include the administration of the Electronic Data Interface process and the research/management of eligibility discrepancy reports.  Members on the team are responsible for proactively identifying issues to internal processes and vetting out solutions to maximize efficiencies and minimize risks. Daily responsibilities include Carrier Reconciliation & Payment, Client Billing, WSE Eligibility, Field Support and Training. 

Carrier Reconciliation & Payment: Conduct monthly carrier reconciliations of assigned carriers. Average monthly carrier payments valued at $3 billion on an annualized basis.  Monitor carrier activity to ensure that reconciliation files are received or sent on a timely basis.  Perform eligibility data reconciliation.  Create, maintain and modify queries needed to reconcile eligibility data. Create error files to send to regions and/or carriers. Research error files. If carrier system access is available, terminate all identified terminations that have appeared as a discrepancy. Maintain reconciliation files.  When dealing with Paid as Billed carriers, incorporate and manage the Net Zero reconciliation process.

Client Billing: Ensure Client Benefit Billing processes are completed timely and accurately as well as prepare and deliver monthly ACH file. Average monthly client billing is valued at $250 million.   Identify and communicate billing errors to carriers and internal partners.  Ensure all recon and corrections have been made prior to the subsequent billing runs.  Oversee the timely and correct auditing of benefit adjustments. Prepare monthly billing reconciliation files and journal entry worksheets.  Prepare files and reports needed for reclassification of expenses.    

WSE Eligibility:  Manage eligibility communications between carriers and internal partners.  Assist benefit service team with diagnosing and solving eligibility issues.  Run the weekly EDI process and resolve any transmission failures. Actively work and manage the discrepancy report reconciliation process between processes.  Monitor the workflow of electronic eligibility interfaces from creation to carrier receipt.

Field Support & Training: Acts as the liaison between Benefits Billing & Reconciliation and the service teams for billing and adjustment related questions.  Train new associates and cross train team members to ensure the proper backups are in place for each department function.