Insurance Billing Operations Specialist

Overview

This role is essential for maintaining accurate records, ensuring clients are billed correctly, managing billing processes, resolving discrepancies and maintaining effective communication with internal teams.

• Review and release bills from third-party vendor.
• Data Assurance and assist with loading data regarding policy/plan updates in our billing system.
• Ensure the Integrity of Billing Data.
• Process coverage or enrollment corrections.
• Discrepancy Resolution by researching and resolve billing issues
• Act as a Subject Matter Expert to provide guidance and support to colleagues on processing and system functionalities.
• Assist with special projects.
• Deliver on all key performance metrics.
• Other supporting duties as assigned which are reasonably within the scope of the duties in this job classification.
• Maintain confidentiality of all information and abide with HIPAA and PHI guidelines at all times.
• Actively supports and complies with all components of the compliance program, including, but not limited to, completion of training and reporting of suspected violations of law and Company policy.
• Maintains confidentiality of all information; abides with HIPAA and PHI guidelines at all times.
• Reacts positively to change and performs other duties as assigned.

• Associate’s degree or 2-5 years of related experience in insurance administration or a similar field
• Proficiency in Microsoft Office Suite and adept at learning insurance software/systems
• Excellent oral, interpersonal and written communication skills
• Exceptional attention to detail
• Strong analytical, problem-solving skills
• Flexibility and the ability to multi-task
• Ability to work independently, with management and/or with other Team Members
• Excellent interpersonal skills.
• Must be detail oriented and self-motivated.
• Excellent customer service skills.
• Anticipate needs in a proactive manner to increase satisfaction.
• The Company reserves the right to modify any bonus/commission structure prospectively at any time for any reason. A bonus/commission is not considered earned until it is paid, and the employee remains with the Company at the time of payment
• Take ownership of job responsibilities by initiating prompt and appropriate follow up and/or action to problems.