Senior Insurance Accountant-Peak Health

About the role

Performs a wide range of professional accounting functions in accordance with Generally Accepted Accounting Principles (GAAP) and Statutory Accounting Principles (SAP) to support the month-end financial statement process of Peak Health entities. Completes documentation and schedules during month-end, budget preparation, and external audit. Prepares quarterly and annual statutory reporting, filings, and compliance tasks. Provides financial guidance to department managers to help control costs and provide organization-wide efficiencies.

Responsibilities

• Aid in the planning and build out of statutory quarterly and annual financial statements, including coordination and preparation of all footnote disclosures, management discussion and analysis, and internal controls.
• Track, manage, and submit all U.S. (State based and NAIC) finance related regulatory fees and filings.
• Make, record, and reconcile government business capitated payments.
• Prepare and file State-Specific Finance Forms and supplements including various schedules.
• Monitor due dates and ensure timely compliance with state filing deadlines pertaining to finance filings.
• Track and submit renewals, fees, and changes in company information to each state regulator.
• Coordinate with regulatory reporting function to ensure finance accountabilities align with overall regulatory filing calendar.
• Correspond with regulators proactively as needed.
• Partner with applicable parties to ensure proper support of general ledger data/applications supporting external statutory accounting and financial reporting.
• Reconcile and explain GAAP vs STAT differences, particularly in areas like loss reserves and premium recognition.
• Manage risk-based capital (RBC) calculations, asset admissibility, and premium deficiency testing.
• Oversee reinsurance accounting, including ceded/assumed premiums and recoverables.
• Support loss reserve development, including IBNR estimation and actuarial collaboration.
• Respond to state regulatory inquiries to support routine financial inquiries.
• Analyze underwriting results and trends impacting statutory profitability.
• Reconcile cash accounts associated with claim disbursements associated with government products.
• Accountable for ensuring governmental products premium billing process is accurate.
• Reconcile Medicare Advantage Prescription Drug payable and receivables, including cost sharing programs and rebates.
• Assist in accounting and treasury management of the investment portfolio.
• Coordinate with the tax department in accounting for and transacting various regulatory taxes.
• Support the accounting classification of expenses between Medical and Administrative.
• Support the development of regulatory rate setting by assisting in the provision of administrative expense actuals and projections.
• Support the filing of various regulatory financial schedules and attestations, including but not limited to MLR filings, Medicare DIR filings, etc.
• Coordinate with the Actuarial and Operational Analytic functions to maintain risk adjustment accruals.
• Develop strong relationships with department managers to help coordinate and monitor financial controls over the organization’s cost centers according to approved budget guidelines.
• Coordinate accounting and financial processes to maximize efficiency in daily accounting operations.
• Ensure that internal control measures are being followed.
• Maintain general ledgers to complete and submit accurate financial data during month-end process according to predetermined deadlines.
• Lead and coordinate month-end variance analysis.
• Oversee and review month-end general ledger reconciliations.
• Directly supervise the work and development of assigned Accounting Department staff.
• Coordinate other staff duties to accomplish department goals and objectives.
• Delegate projects/duties as necessary.
• Develop and submit analytical financial data as needed by department director/manager.
• Assist in completing and compiling financial support documentation for budget and external audit purposes.
• Assist in coordination of the budget and external audit review.
• Train new personnel and monitor their progress.
• Participate in educational opportunities as provided by Peak Health to enhance skill related abilities.
• Complete other duties as assigned by manager.
• Support performance improvement and quality assurance initiatives.

Requirements

• Bachelor’s degree in accounting or related field.
• Five years of insurance accounting experience.
• Five years of Health Insurance Accounting experience required, preferably with experience directly in Medicare Advantage or Medicaid.

Preferred qualifications

Statutory regulatory accounting experience highly preferred.

Physical requirements

Employee may need to sit during extended periods of time. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Working environment

The employee will be working in an office environment. Must be able to use a computer, answer the telephone, and use other office equipment (fax, copier, printer). Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Skills & abilities

• Ability to work with computer databases and spreadsheet software.
• Excellent organizational skills, attention to detail, accuracy, time management, and deadline adherence.
• Strong verbal and written communication skills; analytical and interpretive skills.

Additional details

Scheduled Weekly Hours: 40. Exempt position. Company: PHH Peak Health Holdings. Cost Center: 541 PHH Accounting. Address: 1085 Van Voorhis Rd, Morgantown, West Virginia.