Responsible for Member Billing processes, analyzing and reporting member premium bill information. Ensures timely and accurate creation and mailing of member invoices. Oversees the Premium Bill Delinquency and disenrollment process. Responsible for the oversight of vendors to ensure adherence to service level agreements. Produces month-end billing reports as required.
- Provide oversight and direction to BPO to assure Member Billing activities are completed timely and accurately.
- Works closely with BPO vendor to ensure timely and accurate processing of premium billing activities.
- Responds to questions and inquiries from BPO clients
- Oversees and reconciles premium payment methods (e.g., SSA, ACH etc.).
- Prepares, reviews and analyzes premium payment information for accuracy and completeness.
- Responsible for month-end reporting
- Other deliverables may include premium payment reconciliations, member refund processing, account delinquency and disenrollment for failure to pay premiums
- Assists with the preparation of various billing or regulatory reports and/or statements for management and/or parties external to organization (e.g., auditors, customers, providers, BCBSA, CMS, etc.).
- Participates in internal and external audits
- Attends daily weekly and monthly billing related meetings as required
- Assists with drafting of policies and develops desk level procedures for the department to help assure clarity in department practices and adequate internal controls.
- Interfaces with various departments, management and individuals' external to Advantasure
- Responds to adhoc requests and inquiries. Performs other assignments, duties or functions as assigned by management.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS EDUCATION:
Bachelor's Degree in Accounting, Finance, Business or related field required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE:
Two years experience in related field. Strong analytical, organizational and problem-solving skills. Good verbal and written communication skills. ADDITIONAL EXPERIENCE FOR SENIOR BILLING SPECIALIST:
Four years experience in a related field. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
Additional SKA's required for Senior Billing Specialist:
- Knowledge of Medicare Advantage processes and Centers for Medicare & Medicaid Services (CMS) guidelines.
- Proficient in current industry standard PC applications and systems (e.g., Excel, Word, etc.).
- General knowledge of Generally Accepted Accounting Principles (GAAP).
- Ability to work independently, within a team environment and with multiple priorities
- Ability to effectively interface with various levels of management internally and as well as contacts outside the organization
- Ability to work under general supervision in an environment where there are certain deadlines.
- Excellent verbal and written communication skills to effectively communicate financial information to financial and non-financial individuals.
- Excellent analytical, organizational, problem solving skills and the ability to identify and analyze accounting and business issues.
- Strong Microsoft Office Suite and Access skills are required.
- Strong knowledge and application of forecasting models.
- Strong human relations, analytical, problem solving, influencing and decision-making skills required.
- Excellent project management and leadership skills required.
- Excellent oral and written communication skills, including the ability to complete and present reports and presentations.
Work is performed in an office setting with no unusual hazards or remotely. 20% travel may be required as needed.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. Diversity is valued, and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.
This job has expired.