Reconciliation Analyst - Eligibility

Reconciliation Analyst - Eligibility

SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Remote Opportunity

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

Summary:

Responsible for monthly, weekly and daily reconciliation of memberships and resulting payments, in a manner consistent with regulatory requirements.

1.Formal Education Required:

a.Associates Degree in a related field or equivalent combination of education and experience

2.Experience & Training Required:

a.3+ years performing same or similar responsibilities. Relevant experience includes: Regulatory and/or accounts receivable responsibilities in a healthcare environment, working knowledge of Amisys and Macess systems, and/or general knowledge of member eligibility functions and data management.

3.Other Skills, Competencies and Qualifications:

a.Word at an intermediate level

b.Excel at an intermediate level

c.Access at a basic level

d.Ability to clearly and concisely communicate instructional and operational information verbally and in written form that may include correspondence, reports, instructional materials, system designs; ability to provide instruction and guidance required to supervise day-to-day departmental operations; ability to effectively interface with internal staff, mid-upper management professionals and general public.

e.Ability to apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.

f.Develop technical reports, policies and procedures, and processes that usually affect one department.

g.Demonstrate high degree of organization and attention to detail.

h.Work effectively both autonomously and in a team-oriented environment.

i.Operate standard office machines.

j.Organize and manage time to accurately complete tasks within designated timeframes in a fast-paced environment.

k.Maintain current knowledge of and comply with regulatory and company policies & procedures.

l.Maintain confidentiality of patient and business information.

m.Flexible: ability to adjust work hours to meet business demands.

n.Ability to work in a dynamic and changing work environment.

4.Level of Physical Demands:

a.Sit for prolonged periods of time.

b.Bend, stoop and stretch.

c.Manual dexterity to operate computer, phone, and standard office machines.

Equal Opportunity Employer/Veterans/Disabled

$28.10/hr - $42.15/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

• Basic Life and Accidental Death & Dismemberment (AD&D)
• Supplemental Life and AD&D
• Dependent Life Insurance
• Short-Term and Long-Term Disability
• Accident Insurance, Hospital Indemnity, and Critical Illness
• Retirement Savings Plan
• Flexible Spending Accounts - Healthcare and Dependent Care
• Employee Assistance Program (EAP)
• Identity Theft Protection
• Pet Insurance
• Education Assistance
• Daily Pay