Senior Insurance Accountant-Peak Health

WVU Medicine

About The Position

Performs professional accounting functions in accordance with Generally Accepted Accounting Principles (GAAP) and Statutory Accounting Principles (SAP) to support month-end financial statements for Peak Health entities. Prepares documentation and schedules for month-end, budget preparation, and external audits; prepares quarterly and annual statutory reports and filings; and provides financial guidance to department managers to help control costs and improve organization-wide efficiency. The role supports statutory financial reporting and regulatory compliance, including coordinating financial schedules and filings, managing regulator communications and deadlines, and ensuring financial reporting aligns with regulatory calendars. It also supports general ledger accounting, reconciliations, analysis of GAAP-to-statutory differences, government product accounting, reinsurance, reserves, risk-based capital, investments, taxes, and regulatory rate-setting work. The accountant partners with department managers and cross-functional teams to maintain financial controls, monitor cost centers against budgets, improve accounting processes, and provide financial analysis and documentation. The position directly supervises and develops assigned accounting staff and helps coordinate department work, training, month-end close, budgeting, and external audit support.

Requirements

Bachelor’s degree in accounting or a related field.
Five years of insurance accounting experience.
Five years of health insurance accounting experience; experience directly in Medicare Advantage or Medicaid is preferred.
Ability to work with computer databases and spreadsheet software.
Excellent organizational skills, attention to detail, accuracy, time management, and adherence to deadlines.
Strong verbal and written communication skills.
Analytical and interpretive skills.

Nice To Haves

Experience directly in Medicare Advantage or Medicaid.
Statutory regulatory accounting experience is highly preferred.

Responsibilities

Aid in planning and developing statutory quarterly and annual financial statements, including footnote disclosures, management discussion and analysis, and internal controls.
Track, manage, and submit 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, supplements, and schedules.
Monitor filing due dates and ensure timely compliance with state finance filing deadlines.
Track and submit renewals, fees, and changes in company information to state regulators.
Coordinate with regulatory reporting to align finance responsibilities with the regulatory filing calendar.
Communicate proactively with regulators as needed and respond to state regulatory inquiries regarding routine financial matters.
Partner with relevant parties to ensure general ledger data and applications support external statutory accounting and financial reporting.
Reconcile and explain GAAP and statutory accounting differences, particularly for loss reserves and premium recognition.
Manage risk-based capital calculations, asset admissibility, and premium deficiency testing.
Oversee reinsurance accounting, including ceded and assumed premiums and recoverables.
Support loss reserve development, including IBNR estimation and collaboration with actuarial teams.
Analyze underwriting results and trends affecting statutory profitability.
Reconcile cash accounts related to claim disbursements for government products.
Ensure the accuracy of governmental products premium billing.
Reconcile Medicare Advantage Prescription Drug payables and receivables, including cost-sharing programs and rebates.
Assist with accounting and treasury management for the investment portfolio.
Coordinate with the tax department on accounting for and transacting regulatory taxes.
Support expense classification between medical and administrative expenses.
Support regulatory rate setting by providing actual and projected administrative expense information.
Support filings of regulatory financial schedules and attestations, including MLR and Medicare DIR filings.
Coordinate with actuarial and operational analytics functions to maintain risk adjustment accruals.
Build relationships with department managers to coordinate and monitor financial controls over cost centers in accordance with approved budget guidelines.
Coordinate accounting and financial processes to improve daily accounting operations and ensure internal controls are followed.
Maintain general ledgers and submit accurate financial data during month-end according to 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 staff duties, delegate projects as needed, and support department goals and objectives.
Develop and submit analytical financial data as requested by department leadership.
Prepare and compile financial supporting documentation for budgets and external audits.
Assist in coordinating budget and external audit reviews.
Train new personnel and monitor their progress.
Participate in educational opportunities offered by Peak Health to enhance job-related skills.
Complete other duties as assigned by the manager.
Support performance improvement and quality assurance initiatives.