Data Reporting Manager (TPA)

Role Purpose:

To establish full control of TPA providers' financial reconciliation and payments with ensuring accuracy of financial data and avoiding over / under payments to providers and ensuring discounts are received for TPA.

To project, analyze and report TPA’s expected claims every month while providing insights on cost trends and managing the Business Intelligence (BI) and Data warehousing system to support and strengthen the reporting, analysis and forecasting capability

Accountabilities:

Projection and Analysis

• Manage the design and enhancement of TPA Net Billed Summary models capable of drilling claims analysis with relevant provider details, member details and any other aditional required details.
• Responsible for buidling and updating the TPA pre funding report for all regions and reporting the projected claims amount to TPA customers on a monthly basis
• Project and enhance the cost per member model
• Update the financials of the TPA custom reporting dashboard summary on a quarterly basis.
• Arrange relevant report packages and analysis for all business aspects

 Provider Control (TPA)

• Administer the financial reconciliation process for providers to ensure accuracy of statements.
• Approves the daily provider payments prepared by the team before submitting to Finance Operations for payment accuracy
• Manage the financial reconciliation process for providers
• Analyze data, interpret results and indicate the reliability of findings of key forecasting trends for providers

Regulatory & External Audit

Ensure that the reporting system and provider payments are well supported by documents through policies & procedures to be ready for the TPA external audit

People Development

• Manage 1 senior officer. Responsible for his/her career planning and growth in the company.
• Conduct ongoing 1:1 session and coaching.
• Insure the team responsibilities and objectives are inline with the company goals and targets

Years of Experience 

• 2-4 years of experience in financial analysis, data analysis

Skills Required 

• Strong MS office skills
• Extensive knowledge of statistical modelling techniques such as regression, seasonality analysis and other prediction techniques
• Strong data management and analytical reporting skills
• Analytical and reporting skills with a good understanding of the business drivers

Other Requirements

• BSC Degree in Finance, Accounting, Actuary, or other related major
• Strong presentation and communication skills
• Process and results oriented, with strong attention to details