Financial Systems & Operations Specialist
1 day ago
Austin
Job Description Location: Remote (Texas preferred) About Us Health Admins is a leading third-party administrator in the healthcare space. Our Vision is to radically improve the way individuals interact with the healthcare system. We are committed to providing innovative and efficient health care solutions to our clients, ensuring they receive the best possible care and service. Our team is currently seeking a highly skilled and experienced Financial Systems Accountant to join our dynamic team. What We Are Looking For Our ideal candidate will play a crucial role in managing our financial environment, optimizing its performance, and driving continuous improvements to support our business goals and enhance our service delivery. Every Team Member is Driven by a Commitment to Live out These Values: * Be Authentic: Be true and honest * Be Helpful: Pitch in and help * Be Innovative: Seek & embrace innovation * Be Accountable: Do what you say you are going to Employees are expected to embrace our core values by being “A Hero in Action.” These values lay the foundation for the way we engage with each other and with our clients. They form the guardrails for our decision making and approach to problem solving. Summary/Objective: Health Admins administers healthcare sharing programs and third-party administration services across multiple entities, serving approximately 150,000 lives. The financial operations span five interconnected systems: Enrollment 123, Salesforce, QuickBooks, Merchant Processors, and Escrow accounts. The Financial Systems & Operations Specialist is responsible for executing the company’s core financial operations and developing deep expertise in the systems, data flows, and business processes that support them. This role sits at the intersection of business analysis, financial analysis, and operations—reconciling data across systems, investigating discrepancies, translating financial policies into system requirements, and ensuring the processes that move money through the organization work correctly end-to-end. Today, each system operates in relative isolation and process changes happen without structured notification. This role bridges those gaps by becoming the subject-matter expert on how financial data moves across systems, validating that controls are functioning, and clearly communicating changes to the teams that depend on accurate financial operations. Key Responsibilities: 1. Ownership Mapping & Process Documentation Document and maintain clear accountability for every step of the payment lifecycle, from initiation through bank reconciliation. * Map and formally document who is accountable for each segment of the payment journey across all systems and teams. * Identify gaps where no named owner exists and work with the Operations and Finance to resolve ambiguity. 2. Policy-to-System Translation & Change Management Translate complex financial rules into actionable system requirements and serve as the communication bridge between Finance, Operations, and IT. * Partner with the Financial Controller to document governing policies (contribution-to-coverage eligibility, escrow governance, revenue recognition, exception authority, delinquency and reinstatement rules) and convert each into clear If/Then logic. * Own the validation loop: when a process or system change is deployed, verify it operates as designed through structured testing and parallel runs. When it breaks, diagnose the root cause and re-validate. * Serve as the primary change communication point. When a financial process, policy, or system behavior changes, deliver clear, timely, written updates to Enrollment Admin, Member Services, Account Management, and IT/vCIO on what changed, why, and what it means for their workflows. * Maintain a change log for all financial process and policy updates. No change goes live without documented notification to affected teams. 3. Cross-System Reconciliation & Analysis Execute monthly reconciliation processes across all financial systems, investigate variances, and produce analytical reporting. * Perform monthly three-way matches between merchant processors, escrow bank accounts, and the member database. * Build and maintain the full reconciliation chain: merchant settlements to escrow deposits, escrow to E123 recorded payments, E123 to Salesforce coverage eligibility, Salesforce claims payments to escrow disbursements, and fee draws to earned payments. * Investigate and resolve cross-system variances before they impact members or account managers. * Produce monthly reconciliation reporting with exception detail, trend analysis, and root-cause summaries for leadership review. 4. Payment Integrity & Leak Detection Proactively audit financial systems to identify payment failures and billing anomalies that create financial exposure. * Replace the current manual monitoring with a structured audit process that catches never-initiated payments, declined payments, and reposting anomalies. * Track and escalate recurring payment failures, including known failure modes where declined recurring payments are removed and members default to one-time payments without re-enabling recurring billing. * Own group billing reconciliation and decline detection for current and new clients, ensuring failures are caught in real time rather than surfaced months later. * Develop and maintain dashboards or reporting views that surface payment integrity risks on a weekly cadence. 5. Revenue Validation Ensure administrative fee draws are calculated against settled, stable payment data and flag variances before they flow into financial reporting. * Validate that fee draw calculations use settled payment data rather than figures affected by E123 reposting or in-flight transactions. * Support the Financial Controller in operationalizing the revenue recognition policy. * Flag and investigate any fee draw variances, providing supporting data and analysis to Finance before reporting deadlines. 6. Escrow Operations & Governance Execute day-to-day escrow account operations while maintaining fiduciary controls and proper segregation of duties. * Maintain the escrow subledger and execute treasury operations for member funds across all entities. * Monitor and reconcile dual bank account activity for current and new clients. Ensure monthly transfers are timely and accurate. * Enforce established governance controls and authorized fee-draw workflows, escalating exceptions to the Financial Controller. 7. Decline Management & Payment Resolution Own the full decline lifecycle as a structured, data-driven process—from detection through resolution. * Manage the complete decline lifecycle: detection, member and group notification, retry coordination, and escalation to Account Management only after resolution attempts are exhausted. * Enforce client-specific payment method policies (e.g., ACH-only) and flag any exceptions for leadership review. * Analyze decline patterns to identify systemic issues versus one-off failures, and recommend process or system improvements to reduce recurrence. 8. System Change Review & IT Guardrails Serve as the financial operations reviewer for system updates that touch payment or escrow data flows. * Review proposed system changes for financial and operational impact before deployment. System releases affecting financial data should include this role's documented review as part of the deployment process. * Define pre-deployment verification and circuit-breaker requirements to prevent cascading failures across interdependent systems. * Participate in IT release planning and QA cycles for any changes touching the payment lifecycle. 9. New Client Financial Onboarding Define and execute the financial readiness requirements that must be met before any new client goes live. * Produce and maintain a financial readiness checklist covering merchant processor configuration, escrow account setup, E123 billing period creation, and bank account verification. * Validate that all financial systems are correctly configured for a new client before the first payment cycle runs. 10. Exception Management & Escalation Execute and standardize the approval process for high-dollar write-offs, refunds, retroactive reinstatements, and priority reimbursements. * Execute exception decisions within defined authority levels and escalate above-threshold items to the Financial Controller with supporting analysis. * Own the escalation path for high-priority reimbursements outside the standard monthly cycle, plus proactive exception reporting to identify overdue activities before members are impacted. * Serve as the primary liaison to Account Management for payment-related member escalations, maintaining a formal handoff protocol. Required Qualifications: * 3–5 years of experience in financial operations, systems reconciliation, or business/financial analysis in a multi-entity or multi-system environment. * Demonstrated ability to work across multiple interconnected systems (ERP, CRM, merchant processing, claims/eligibility platforms) and synthesize data across them. * Experience performing reconciliation processes, controls documentation, and exception reporting across complex financial workflows. * Track record of translating business and financial requirements into clear system specifications and working collaboratively with technical teams. * Strong analytical skills with the ability to investigate variances, identify root causes, and communicate findings clearly to both technical and non-technical stakeholders. * Familiarity with electronic payment methods and settlement processes (ACH, credit card, merchant processing). * Advanced Excel proficiency (lookups, pivots, conditional logic, data validation). SQL or BI tool experience is a plus. * Bachelor’s degree in Accounting, Finance, Business Administration, Information Systems, or a related field. Preferred Qualifications: * Healthcare payer, TPA, health plan, or health share administration experience. * Experience with Salesforce in a financial, eligibility, or operational context. * Familiarity with E123 or similar enrollment and billing platforms. * Experience building reconciliation frameworks or controls documentation from scratch. * Background reviewing IT deployments for financial or operational impact before go-live. * Deep knowledge of payment settlement cycles, decline handling, retry logic, and payment method enforcement. * Background in data analysis, business analysis, or process improvement methodologies. * Prior involvement in PE-backed organizations, sell-side readiness, or new client financial onboarding. * CPA, CPA-track, or other relevant certification preferred but not required. What We Offer * Competitive salary and benefits package * Dynamic and innovative work environment * Opportunities for professional growth and development * Remote work flexibility Equal Opportunity Statement We are deeply committed to building a workplace and global community where inclusion is not only valued but prioritized. We are proud to be an equal opportunity employer, seeking to create a welcoming and diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, family status, marital status, sexual orientation, national origin, genetics, neuro diversity, disability, age or veteran status, or any other non-merit based or legally protected grounds. We are committed to providing reasonable accommodation to qualified individuals with disabilities in the employment application process.