Premium Billing Specialist

Essential Functions

• Provide exceptional customer support to Select Health Individual members through inbound calls and live chat.
• Coincide with employer group representatives to reconcile basic account adjustments and facilitate accurate payment processing.
• Respond to inquiries and provide clear guidance on billing, enrollment, and account-related processes.
• Partner with internal departments to troubleshoot and resolve billing and enrollment concerns.
• Process member payments in accordance with established financial controls and compliance protocols.
• Aid members and agents in navigating enrollment platforms and accessing documentation while ensuring data privacy and regulatory compliance.
• Maintain accurate and detailed records of customer interactions and account updates.
• Evaluate member accounts to determine reinstatement eligibility and calculate outstanding payment requirements in alignment with billing policies and plan guidelines.
• Review and validate peer-submitted reinstatement requests to ensure accuracy, completeness, and alignment with established billing and enrollment standards.
• Adhere to internal policies and state/federal regulatory requirements.
• Consistently meet or exceed performance metrics including productivity, accuracy, and customer satisfaction.

Skills

• Professional Phone Communication
• Health Plan Eligibility Knowledge
• Secure Payment Processing
• Accounts Receivable
• Written and Verbal Communication
• Customer Experience Excellence
• Data Privacy and Confidentiality
• Documentation and Recordkeeping
• Digital Literacy and System Navigation
• Typing Speed and Accuracy
• Proficiency in Microsoft Office Suite (Excel, Outlook, Teams)
• Stress Management and Resilience
• Task Prioritization
• Active Listening Techniques
• Time and Workflow Management

Qualifications

• Minimum Qualifications: Proven experience in a customer-facing role, preferably in healthcare or insurance. Strong proficiency in CRM systems and data entry, with attention to detail. Excellent communication and interpersonal skills across multiple channels. Demonstrated ability to multi-task, prioritize, and manage time in a fast-paced environment. Effective problem-solving skills and ability to remain calm under pressure.
• Preferred Qualifications: Background in healthcare finance or enrollment operations, including AP/AR, eligibility verification, or payroll. Experience with process optimization and negotiation. Strong organizational and analytical skills, including data collection and reporting.