Billing Implementation Specialist

About the role

The Billing Implementation Specialist serves as Color's primary operational point of contact for payer onboarding and billing implementation. This role is responsible for coordinating payer setup activities from kickoff through billing readiness, ensuring implementation milestones stay on track and issues are driven to resolution. You'll work closely with payer representatives, Customer Success Managers, Revenue Cycle, and Product teams to ensure billing processes launch successfully, and that billing workflows and playbooks optimize Color’s billing ability within the constraints of payers’ billing requirements.

Responsibilities

• Coordinate end-to-end billing implementations for new payer and health plan launches, from kickoff through billing readiness and go-live.
• Guide payers through Color's standard billing implementation process, including implementation meetings, billing setup, claims testing, and required milestones.
• Own implementation timelines by tracking progress, coordinating next steps, proactively following up with stakeholders, and escalating risks or blockers as needed.
• Identify risks and develop mitigation strategies to ensure successful billing operations.
• Relationship Management with Payer Billing Contacts
• Serve as the primary day-to-day contact for billing implementation, building strong relationships with payer billing representatives and partnering with Customer Success Managers throughout implementation.
• Answer implementation questions, facilitate meetings, and work with payer billing contacts to resolve issues and ensure successful launches.
• Billing Operational Support
• Track billing KPIs (e.g., first-pass claim acceptance, denial rates, and payment turnaround times).
• Configure billing integrations through major payer networks (e.g., Cigna, Anthem, UnitedHealthcare) via EDI or API pathways.
• Validate member eligibility and ensure accurate payer setup for claim adjudication.
• Troubleshoot billing data or eligibility issues in collaboration with billing partners, engineering and client success teams.
• Develop and maintain standard operating procedures (SOPs) for consistent, compliant billing practices.
• Investigate and resolve implementation issues related to payer setup, claims processing, and billing readiness, and claims denials, partnering with internal teams as needed.
• Maintain implementation documentation, trackers, and standard operating procedures to support consistent and scalable onboarding processes.
• Analyze billing workflows to identify opportunities for improvement, automation and process optimization.

Requirements

• 5+ years of experience in revenue cycle management, payer relations, billing operations or customer implementation.
• Experience managing implementations with ASOs/TPAs or health plan partnerships is strongly preferred.
• Experience working with health plans, TPAs, provider organizations, or healthcare billing.
• Excellent organizational and project management skills.
• Exceptional communication, stakeholder management, and cross-functional coordination skills.
• Ability to manage multiple implementations simultaneously.
• Comfortable leading meetings with external partners.
• Strong follow-up and stakeholder management skills.
• Ability to independently drive work forward and resolve issues.
• Understanding of CPT/HCPCS codes, payer credentialing, and claim lifecycle management.
• Experience managing implementations with ASOs/TPAs or health plan partnerships is strongly preferred.

Qualifications

• Education: Bachelor's degree in Healthcare Administration, Business Administration, or a related field.
• Professional Certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar certification.

Skills

• Strong knowledge of healthcare billing and coding standards (e.g., CPT, HCPCS).
• Experience with healthcare billing systems and software.
• Proficiency in Microsoft Office Suite.
• Excellent problem-solving and analytical skills.
• Ability to work independently and as part of a team.
• Strong interpersonal and communication skills.

Benefits

• Competitive salary
• Comprehensive medical, dental, vision, life, and disability benefits
• 401k match
• Monthly phone and wifi stipend for employees, annual ergonomic stipend
• Generous vacation policy, paid holidays and company-wide recharge days
• Equal paid parental leave for birthing and non-birthing parents
• Free cancer screening and prevention resources for employees and their adult dependents

Pay

Base Salary Range: $75,000 - $125,000/year

Schedule

Full-time