The Revenue Accountant is primarily responsible for the accurate billing, accounting, reconciliation, and reporting of individual member premium revenue associated with government insurance products. In addition, this role will support billing and collection to various customers of Peak, including but not limited to self-funded and fully insured clients. This role ensures compliance with regulatory requirements, supports financial reporting, and collaborates with cross-functional teams to maintain data integrity across premium billing, collections, and revenue recognition processes.
MINIMUM QUALIFICATIONS :
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Bachelor’s degree in accounting or finance.
EXPERIENCE:
1. Two (2) years of accounting experience.
PREFERRED QUALIFICATIONS :
EXPERIENCE:
1. Understanding of health insurance regulatory environment.
2. Experience with health insurance accounting is required, including experience supporting government insurance products (e.g., Medicare and/or Medicaid).
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. Perform monthly accounting for member premium revenue, including accruals, adjustments, and deferrals. Ensure information technology cycles and operational processes complete on schedule.
2. Reconcile premium billing systems to the general ledger and resolve discrepancies timely.
3. Analyze premium receivables, cash applications, and aging to ensure accuracy and completeness.
4. Monitor and report on unapplied cash and premium variances.
5. Prepare journal entries and account reconciliations in accordance with GAAP and statutory accounting principles (SAP), as applicable.
6. Support monthly, quarterly, and year-end close processes.
7. Assist with regulatory reporting requirements
8. Ensure compliance with internal controls, SOX requirements, and audit standards.
9. Investigate and resolve complex premium issues, including eligibility discrepancies, retroactive adjustments, and billing errors.
10. Partner with Enrollment, Billing, Actuarial, and IT teams to address root causes of discrepancies.
11. Perform trend analysis on premium revenue and membership data.
12. Support system implementations, upgrades, loading of premium rates and testing related to premium billing and accounting.
13. Identify and implement process improvements to enhance efficiency and accuracy.
14. Maintain documentation of accounting workflows and procedures.
15. Assist internal and external auditors by providing documentation and explanations for premium-related balances and processes.
16. Support ad hoc financial analysis and special projects as needed.
17. Coordinate with the enrollment department as it pertains to member grace periods and assist in policy development.
18. Responsible for managing a queue of CRMs related to member premium.
19. Support billing and collection activities to Third Party Administration customers and group insurance customers as applicable.
20. Assist in material development and education to support the navigation and modality of premium invoice payment options.
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 for 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. Fast-paced, deadline-driven environment
2. Cross-functional collaboration with finance, operations, and compliance teams
SKILLS & ABILITIES:
1. Ability to manage multiple priorities and meet deadlines.
2. Excellent organizational skills, attention to detail, accuracy, time management, and deadline adherence.
3. Strong verbal and written communication skills; analytical and interpretive skills.
4. Strong understanding of GAAP; knowledge of statutory accounting (SAP).
Additional Job Description:
HYBRID (2 days/week on-site Morgantown, WV)
- flexibility to travel on-site more if needed
HEALTH INSURANCE EXPEREINCE HIGHLY PREFERRED
- knowledge of ACA and Medicare Premium billing
- knowledge of Statutory Accounting Principles (not GAP)
Scheduled Weekly Hours:
40
Shift:
Exempt/Non-Exempt:
United States of America (Exempt)
Company:
PHH Peak Health Holdings
Cost Center:
541 PHH Accounting
Address:
1085 Van Voorhis Rd
Morgantown
West Virginia
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.
