Virginia Premier Health Plan, Inc.

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Supervisor, Accounting Operations

Supervisor, Accounting Operations

Job Locations 
US-VA-Richmond
Job ID 
2017-4324

Job Description

Overview

This position is responsible for directing the accurate and timely payment of all Fee For Service claims (IDX and QNXT) and monthly Capitation payments.  Systems utilized are Lawson and Document Express for IDX claims/cap.  QNXT and Payspan are utilized for QNXT claims/cap payments.   Ensures operating integrity and coordinates interdepartmental activities to resolve provider accounts payable/receivable issues

 

Responsibilities

  • Supervises a staff of five.
  • Plans, coordinates, and monitors the daily activities of the staff, ensuring smooth, efficient work flow and adherence to objectives.
  • Ensures data integration/reconciliation of all systems.
  • Oversees daily IDX and QNXT FFS claims payments, monthly capitation payments for all lines of business (Medallion3, VCC, VPCC, DSNP, MLTSS, MAPD).
  • Manages IDX vendor interface files and change gear ticket system for vendor changes for all lines of business.
  • Ensures timely and accurate filing of annual 1099’s to vendors and IRS for all lines of business.
  • Reviews and assists analyst’s weekly research of AP230 outstanding balance issues.
  • Reviews returned checks and manages resolution by working with PDT.
  • Oversees refund process by approving the processing through Lawson
  • Approves stop payments requests.
  • Reviews and assists analyst’s research of items on AP520 weekly that do not interface to Lawson.
  • Researches remit/check differences.
  • Responds to claims customer service requests
  • Other accounting duties/projects as assigned

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Bachelor's degree in Accounting

SPECIAL KNOWLEDGE AND/OR SKILLS 

 

  • In-depth knowledge of automated financial and accounting reporting systems
  • Strong understanding of GAAP and internal control environment
  • Ability to effectively plan, organize and complete multiple complex activities, priorities and assignments on a timely basis.
  • Ability to understand a complex system architecture in which data flows between interconnected systems managed by different teams
  • Ability to analyze statistical and financial reports
  • Excellent organizational and interpersonal skills
  • Ability to work effectively with co-workers as a team member
  • Ability to communicate effectively and professionally, both orally and  in writing
  • Advance Excel skills required

 WORK BACKGROUND/EXPERIENCE

  • 5+  years of related accounting experience required
  • 3+ years of related managerial experience required
  • Healthcare claims experience preferred
  • Lawson experience preferred
  • Previous IDX or QNXT experience helpful

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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