At Triple-S, we are committed to providing meaningful job experiences for Valuable People (Gente Valiosa). We strive for excellence in everything we do, from the way we work together to the way we serve our customers.
When you join Triple-S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.
Let's build healthier communities together, join now!
JOB SUMMARY
ESSENTIAL FUNCTIONS
- Selects the most appropriate method to achieve identified results in a work plan or project.
- Perform regular and ad-hoc accounting and financial analyses or financial and operations management.
- Utilize reporting systems to generate and distribute reports, respond to inquiries, conduct research, identify and resolve problems.
- Identify, recommend, and implement financial planning and analysis process improvements.
- Act as liaison between business unit operations and Payment Integrity functions; ensuring accurate and timely recording of project costs.
- Prepare and reviewing financial reports and presentation for business unit operations related to Payment Integrity functions.
- Estimate and present USI reserve report for Hospital outstanding amount.
- Compile data from the operational areas to provide and present statistics of the operation of Triple S Salud lines of business.
- Provide guidance to the business unit operations personnel about the controls and responsibilities related to the financial input information for the savings reports and communicate to the PI Enterprise Coordinator any changes of the documentation for policies and procedures updating purposes.
- Facilitate communication between the PIO and other health plan teams.
- Host weekly/biweekly/monthly meetings with other TSS/TSA teams to ensure focus on the PI agenda.
- Follow up on next steps and takeaways from any communication, meeting, or conference call.
- Assist the Ideation Team, FWA Team and USI in gathering data and information from other departments for new savings opportunity ideas.
- Assist in analyzing payment policies, fee schedules, specific provider incentives, and other programs which impact reimbursement savings and recovery.
- Serve as the liaison with other TSS/TSA teams as needed.
- Assist in reimbursement analyses related to new lines of business as directed.
- Assist in analysis of other reimbursement specific projects as directed. Perform general ‘ad hoc’ duties and reporting.
EDUCATION
- Bachelor's Degree in Business Administration
EXPERIENCE
Bachelor’s Degree in business administration with a major in Finance or Accounting with 1 to 3 years of finance or accounting experience, preferably with health insurance industry.
LICENSES AND CERTIFICATIONS
- None required
COMPETENCIES
- Manages Ambiguity
- Instills Trust
- Collaborates
- Customer Delight (Employee)
- Action Oriented
It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, sex, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.
Equality Employment Opportunity/Affirmative Action for People with Disabilities/Veterans. Employer with E-Verify to verify the eligibility of employment of all the new employees.
We encourage Veterans and Disabled to Apply.