Claims Finance Manager

Job Description

Job Description

We are looking for an experienced Claims Finance Manager to support health insurance finance operations in Minnetonka. This Long-term Contract position will oversee medical claims accounting, month-end activities, regulatory reporting support, and financial analysis tied to healthcare payer operations. The ideal candidate brings strong expertise in claims finance, reserve analysis, and cross-functional coordination to ensure accurate reporting and compliance in a complex environment.

Responsibilities:

• Oversee weekly medical claims activity, track processing patterns, and investigate unusual fluctuations that could affect financial results or operational timeliness.

• Manage month-end accounting for claims-related transactions by preparing journal entries, updating reserves, and recording financial impacts associated with claims and related obligations.

• Perform monthly reconciliations of claims-related accounts, resolve outstanding variances, and address timing or system-driven discrepancies to maintain ledger accuracy.

• Analyze medical expense results against actuarial expectations, explain key drivers of variance, and support accurate financial close reporting.

• Review plan settlement data, confirm calculation accuracy, and record associated receivable, payable, and cash entries within the general ledger.

• Administer accruals, projections, and payment tracking for healthcare vendor and program-related obligations, including intercompany balances and reserve maintenance.

• Contribute to regulatory and statutory reporting by assisting with data requests, Medicare cost reporting activities, filing support, and audit-related analysis.

• Prepare detailed finance schedules such as claims rollforwards, actuarial reconciliations, redundancy analyses, and other supporting reports for leadership and compliance needs.

• Serve as a finance subject-matter expert for system and platform initiatives by supporting testing, validating outputs, troubleshooting issues, and improving financial data quality.

• Provide team guidance through coaching, regular check-ins, and active participation in leadership discussions and departmental initiatives.

• Bachelor’s degree in Accounting, Finance, or a related discipline is required.
• At least 7 years of progressive experience in healthcare finance, insurance accounting, or medical claims financial management.
• Hands-on background in medical claims processing, claims reserve analysis, and monthly financial close activities.
• Experience supporting Medicare cost reporting, regulatory submissions, and audit documentation within a healthcare payer or health insurance environment.
• Prior leadership, supervisory, or team lead experience with the ability to coach and support colleagues effectively.
• Advanced Excel skills, including complex formulas, pivot tables, and large-volume financial data analysis.
• Experience working with financial and reporting tools such as PeopleSoft, Power BI, Access, QlikSense, or TM1.
• Strong critical thinking, reconciliation, and process improvement skills within health insurance or healthcare payer operations.