Financial Operations Analyst Lead - Payment Integrity Datamining

Location and Work Arrangement This role requires associates to be in-office 1–2 days per week, fostering collaboration and connectivity, while providing flexibility for virtual work. Alternate locations may be considered if candidates reside within a reasonable commuting distance from an office. Responsibilities Lead and coach staff, managing workflow and overseeing day-to-day departmental responsibilities. Conduct operational meetings with staff and assist management in establishing work goals. Prepare management reports and budget variance analysis as required. Develop and execute complex data analysis and strategic report applications from Finance systems. Write queries and macros to enhance Access databases and build new databases to support accurate balance sheet and P&L reporting. Provide decision support and procedural input to ensure processing efficiency does not compromise internal control mechanisms. Interface with IT, documenting and tracking any needed system enhancements, and assist in software releases within the Finance organization. Document responses to external audit requests and ensure proper conversion or shutdown of legacy systems by developing and documenting enterprise solutions for successful transition to core processing systems. Apply technical and operational expertise to commit the department to deliverables on own initiative and use discretion in independent decision-making. Minimum Requirements BA/BS in accounting or finance and a minimum of 5 years of experience in a finance/health insurance field capacity, or equivalent education and experience. Experience with relational databases and mainframe/client‑server report writers. Preferred Skills and Experience Experience working post‑pay reviews, validation, and recovery processes in the healthcare industry. Experience managing multiple projects in various stages to completion. Knowledge of medical billing guidelines and regulations. Familiarity with medical coding systems such as ICD, CPT, and HCPCS. Claim processing experience. Experience with GBD Facets or WGS. Job Details Job Level: Non‑Management Exempt Workshift: 1st Shift (United States of America) Job Family: AFA > Financial Operations Equal Opportunity Employer Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. #J-18808-Ljbffr