Billing Specialist

Responsibilities

• Client Billing Administration
• Create, review, and release monthly premium bills.
• Manage a portfolio of assigned groups and ensure all required billing activity is completed on schedule.
• Apply established billing methodologies, fee structures, and client-specific requirements.
• Billing Review and Quality Control
• Review billing details for inconsistencies, discrepancies, or missing information.
• Investigate billing errors and perform required corrections prior to invoice distribution.
• Verify fees, rates, and administrative charges against approved documentation and contractual requirements.
• Ensure annual renewals, mid-year rate changes, and new group implementations are accurately reflected on invoices.
• Update billing calculations for rate changes, renewals, and client modifications.
• Coincide with Configuration, Eligibility, Finance, and Client Banking teams when rate discrepancies are identified.
• Confirm that billing data aligns with approved client setups and system configurations.
• Documentation and Record Retention
• Follow company naming conventions and documentation standards.
• Organize and store billing files and supporting documentation within approved company systems.
• Maintain audit-ready records for billing transactions, rate changes, and client communications.
• Ensure billing documentation can be easily retrieved for future reference or audit purposes.
• Client and Internal Support
• Respond to client billing inquiries in a professional and timely manner.
• Partner with Client Experience, Member Experience, Eligibility, Finance, Configuration, and Banking teams to resolve billing issues.
• Research invoicing concerns and provide clear explanations regarding charges, adjustments, and billing calculations.
• Communicate effectively with clients, brokers, and internal stakeholders at various organizational levels.
• Performance and Quality Management
• Review production reports and performance metrics throughout the month.
• Meet assigned billing volume and turnaround expectations.
• Maintain established quality audit scores.
• Review and respond to quality audit findings within required timeframes.
• Implement corrective actions when opportunities for improvement are identified.

Requirements

• High School Diploma or GED
• Experience interpreting large data sets and identifying discrepancies.
• Strong mathematical and reconciliation skills.
• Advanced Microsoft Excel skills, including data manipulation, validation, and reporting.
• Proficiency with Microsoft Lists, Excel, and related Microsoft Office applications.
• Ability to navigate billing and operational systems efficiently.
• Strong verbal and written communication skills.
• Ability to explain complex billing concepts to clients and internal teams.
• Professional customer service approach when handling escalated billing concerns.
• Comfortable interacting with clients, brokers, and operational departments.
• Effective time-management and prioritization skills.
• High level of accuracy and attention to detail.
• Strong organizational and documentation skills.
• Follow HIPAA guidelines and protect confidential member information.
• Adhere to established billing processes and operational procedures.
• Maintain compliance with company standards for quality, documentation, and client service.
• Participate in team meetings, training sessions, quality reviews, and continuous improvement initiatives.

Qualifications

• Working knowledge of Word, PowerPoint, Visio, and Copilot.

Skills and Abilities

• Experience interpreting large data sets and identifying discrepancies.
• Strong mathematical and reconciliation skills.
• Advanced Microsoft Excel skills, including data manipulation, validation, and reporting.
• Proficiency with Microsoft Lists, Excel, and related Microsoft Office applications.
• Ability to navigate billing and operational systems efficiently.
• Strong verbal and written communication skills.
• Ability to explain complex billing concepts to clients and internal teams.
• Professional customer service approach when handling escalated billing concerns.
• Comfortable interacting with clients, brokers, and operational departments.
• Effective time-management and prioritization skills.
• High level of accuracy and attention to detail.
• Strong organizational and documentation skills.
• Follow HIPAA guidelines and protect confidential member information.
• Adhere to established billing processes and operational procedures.
• Maintain compliance with company standards for quality, documentation, and client service.
• Participate in team meetings, training sessions, quality reviews, and continuous improvement initiatives.

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate and support the company's diversity and inclusion initiatives

Pay

Competitive compensation package based on experience and qualifications.

Schedule

100% remote position.