Billing Implementation Specialist

Color Health • South San Francisco, CA

48d

About The Position

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. Most implementations follow established billing workflows and playbooks. You'll become the expert in Color's standard billing process, confidently guiding payer partners through implementation requirements, answering questions, and escalating only complex or non-standard scenarios. This role is ideal for someone who enjoys managing multiple projects, building relationships, solving operational problems, and keeping work moving forward.

Requirements

• 5+ years of experience in revenue cycle management, payer relations, billing operations or customer implementation.
• 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.

Nice To Haves

• Experience managing implementations with ASOs/TPAs or health plan partnerships is strongly preferred.
• Experience managing implementations with ASOs/TPAs or health plan partnerships is strongly preferred.

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.
• 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.
• 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.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed