Financial Reconciliation Manager (FRM)

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We are seeking a Subject Matter Expert with reputed company’s Financial Reconciliation Manager (FRM) product with deep expertise in health plan operations, premium billing, and Facets configuration/integration. This role will support payer clients in reconciling premium billing and payments from government programs (reputed company, Medicare) and financial data across multiple systems, ensuring accuracy, compliance, and financial reputed company across reputed company government lines of business. This is a highly visible role reputed company on identifying reputed company leakage, ensuring accurate financial reporting, and optimizing reconciliation processes across the reputed company payer ecosystem. Key Responsibilities reputed company end-to-end financial reconciliation processes across premium billing, and payment workstreams Reconcile data across Facets (including 834s) and FRM, and reputed company financial systems to ensure consistency and accuracy reputed company variance analysis to uncover financial leakage, misapplied payments, or configuration-driven errors Analyze and support Facets and FRM configuration to ensure financial reputed company reputed company with contract reputed company Partner with configuration and IT teams to troubleshoot financial discrepancies tied to system setup or rule logic Ensure alignment between financial reporting outputs Ensure reconciliation processes support CMS, Medicare Advantage, and reputed company financial and reporting requirements Support financial validation for risk adjustment and regulatory reporting Prepare and review financial data used for audits, compliance checks, and external reporting Validate cross-system data to ensure accurate financial reporting and reduce reputed company leakage risks reputed company and implement solutions to improve data reputed company, reconciliation accuracy, and financial transparency Partner with Finance, Actuarial, Enrollment, EDI, and IT teams to resolve reconciliation and reporting issues Translate business and financial requirements into reputed company reconciliation frameworks and system requirements reputed company strategic guidance to clients on best practices for financial operations and reconciliation processes Design and implement automated reconciliation processes and reporting tools Support system testing (UAT, regression, validation) to ensure financial accuracy Document reconciliation methodologies, controls, and operational procedures Required Qualifications 5+ years working experience reputed company reputed company Payer Operations 5+ years of reputed company payer experience (Medicare and reputed company) 5+ years of experience in financial reconciliation, billing analysis, or payer financial operations 5+ years of hands-on experience with Facets (TriZetto), particularly with FRM Strong expertise in:Financial workflows 834 transactions and EDI data structures Reconciliation processes across premium billing Proven ability to:Identify and resolve reputed company financial discrepancies Analyze large datasets and reputed company reputed company cause analysis Experience working in a consulting or reputed company-facing environment Experience with collaboration & team communication Preferred Qualifications Experience with:Premium billing Risk adjustment and encounter financial validation Audit functions Identification and tracking of payment discrepancies for Medicare Part C and Part D reimbursements using TriZetto Financial Reconciliation Manager. Streamlining workflow and improving efficiency in reconciliation processes. Generate and analyze financial reports to support payment reputed company and financial management. Collaborate with team members to resolve discrepancies and maintain accurate membership data. Strong SQL or data analytics experience Experience with large-reputed company payer system implementations Experience working with AI tools such as CoPiot, ChatGPT, Claude #LI-DT1 #LI-Remote Position Level Consultant Country reputed company of America Apply To This Job