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We are an equal opportunity employer currently with over 550 professionals and skilled staff employed across New Jersey in a wide variety of roles.  Regardless of job responsibilities, all LMSNJ employees share a true commitment to serve those who are hurt, who are in need, or who have limited choices--regardless of religious affiliation or background.

Claims Analyst

  • Job Tracking ID: 512088-585581
  • Job Location: Burlington, NJ
  • Job Level: Mid Career (2+ years)
  • Level of Education: BA/BS
  • Job Type: Full-Time/Regular
  • Date Updated: August 11, 2017
  • Years of Experience: 2 - 5 Years
  • Starting Date: ASAP



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Job Description:

 

Lutheran Social Ministries of New Jersey is currently seeking a Claims Analyst to work with our team in Burlington and Jersey City.

Through the power of the Holy Spirit and in response to God’s love as revealed in the Gospel, the mission of Lutheran Social Ministries of New Jersey is to serve those in New Jersey who hurt, who are in need, or who have limited choices.

LSMNJ team members are dedicated to providing healing, hope and hospitality, regardless of religious background through a diversified social ministry program addressing many critical human care needs.

We are seeking employees that share those same values and want to make a difference in the lives of those we serve.

 

This position is full-time offering competitive compensation, a robust benefit package and generous paid time off.

 

General Responsibilities

Prepare, report and analyze monthly claims activity for LIFE program(s), including various business metrics, estimates and reserves, claims analysis, rate development, utilization of services, operating expenses, etc. in collaboration with the members of the management team. Keep current on regular communications from State and Federal agencies, and communicate summary of key points to appropriate managers.  Review the timing, accuracy, and appropriateness of accounting transactions that are processed into the accounting software for the LIFE program(s) in accordance with Generally Accepted Accounting Principles.  Obtain management information and research business transactions as necessary to ensure accurate and timely accounting of transactions.  Analyze monthly financial statements including various business metrics, such as receivables, utilization of services, operating expenses, etc.

 NOTE: This position requires working three days in Burlington (Corporate) office, and two days in Jersey City, with travel reimbursement.          

Essential Duties

 

  1. Supports the mission and values of Lutheran Social Ministries of New Jersey, which is: Through the power of the Holy Spirit, and in response to God’s love as revealed in the Gospel, the mission of the Lutheran Social Ministries of New Jersey is to serve those in New Jersey who hurt, are in need, or have limited choices.
  2. Review and analyze claims and reserve data for program participants.
  3. Act as liaison between LIFE program(s) and Third-party Administrator.
  4. Act as liaison between corporate office and program location(s), including regular site visits, to facilitate gathering of information that will allow proper response to claims and legal documents.
  5. Prepare month-end close workpapers.
  6. Manage Accounts Receivable and follow up on Medicaid status of participants.
  7. Process approved vendors’ invoices into the accounting software accurately and timely.
  8. Research and respond to payment inquiries from vendors in a timely manner.
  9. Perform research of business transactions as necessary.
  10. Review communications from State/Federal agencies, particularly CMS, for relevance to LSMNJ LIFE program(s), and prepare summaries for appropriate management. Follow up to ensure that required deadlines and reporting are met.
  11. Participate in the preparation of the annual operating plan budget.
  12. Manage special projects and perform research as assigned by supervisor.
  13. Complete annual compliance and HIPAA training and exhibits behavior as set forth by the LSMNJ Code of Ethics and Business Integrity in the performance of duties.
  14. Adhere to the Organization’s Policies and Procedures regarding the Compliance Program of the organization and report timely any possible concerns.
  15. Follow all local, state and federal regulations as they pertain to the position.
  16. Other duties as assigned by supervisor, necessary for the efficient operation of the department/facility.

Experience and Skills:

Basic Qualifications

Education/Training/Certifications:         

College degree required; background in Accounting or Finance preferred.

 

Skill(s):     Familiar with managing general ledger accounts and able to close general ledger in accordance with Generally Accepted Accounting Principles.  Able to analyze and articulate salient business issues identified in financial statements.

Effective use of automated, integrated accounting and administrative software.   Excellent EXCEL skills.   Advanced ad hoc reports and schedule preparation.  Effective use of the Internet.   Confidential.

Excellent oral and verbal communication. Able to lead discussions among colleagues on various topics. Also able to summarize State/Federal communications and distribute key points to managers.

Able to do independent research of accounting transactions. 

Pleasant, team-spirited telephone and interpersonal relations.

 

Experience:   Three to six years of experience in all aspects of general accounting in a medium or large sized organization, public accounting firm or equivalent academic or work experience.  Experience in the insurance industry, particularly preparation and analysis of claims adjudication, financial analysis, and corporate reporting, is required.

 

LSMNJ is an Equal Opportunity Employer.