Mgr, Traditional Billing

Horizon Healthcare Services•Newark, NJ

10d•$109,600 - $149,625

About The Position

The Manager, Traditional Billing oversees multiple billing and enrollment teams to ensure timely and accurate billing, enrollment completion, and revenue reporting. The role manages accounts receivable and invoice reconciliation, regulatory audit responses, payment posting and reallocation, premium collection, and manual and electronic enrollment. It also addresses high-profile account delinquencies and recoups and collects premium payments. The position executes monthly, quarterly, and annual revenue reports in partnership with Finance, and is responsible for month-end, quarterly, and year-end financial close for commercial and fully insured group accounts. It is accountable for the annual rate renewal process and quality controls for the Medigap population, and oversees Medicare billing and premium rate validation. The role is accountable for commercial-market revenue and premium collection processes, with annual revenue exceeding $4 billion. The manager drives operational improvement, maintains financial controls and regulatory compliance, manages departmental expenses, leads and develops staff, and represents the billing department in corporate projects and strategic initiatives. The role also builds cross-functional partnerships and coordinates with external vendors supporting enrollment and billing operations.

Requirements

High school diploma or GED required.
Minimum of five years of managerial experience required.
Minimum of five years of billing and enrollment operations experience.
Experience managing in a fast-paced, high-volume, transaction-driven environment.
Strong knowledge of service operations, including customer service call centers, claims administration, membership, enrollment, billing, and premium collection processes.
Experience leveraging emerging technologies, including artificial intelligence and machine learning, to enhance operational efficiency, automate workflows, and improve billing outcomes.
Knowledge of industry trends, regulatory requirements, project management methodologies, and operational best practices.
Thorough understanding of billing, premium collection, accounts receivable, and delinquency management best practices.
Knowledge of financial controls, reconciliation processes, revenue reporting, and audit compliance requirements.
Familiarity with vendor management, service level agreements, and performance monitoring practices.
Understanding of process improvement methodologies such as Lean, Six Sigma, root cause analysis, and continuous improvement principles.
Proven leadership, decision-making, strategic thinking, and problem-solving capabilities.
Excellent written and verbal communication skills and ability to influence stakeholders at all organizational levels.
Strong analytical and quantitative skills, including interpreting data, identifying trends, and developing actionable solutions.
Ability to manage multiple priorities in a fast-paced, high-volume environment.
Skills in relationship management, collaboration, negotiation, and conflict resolution.
Strong project management skills and experience leading cross-functional initiatives and organizational change.
Ability to coach, develop, and motivate teams to meet performance, quality, and customer service objectives.
Results-oriented approach focused on accountability, continuous improvement, and operational excellence.
Ability to evaluate processes, identify efficiencies, and implement business solutions.
Strong organizational skills and exceptional attention to detail and accuracy.
Proficiency in Microsoft Office applications and business reporting tools.
Employees must live in New Jersey, New York, Pennsylvania, Connecticut, or Delaware.

Nice To Haves

Bachelor’s degree in Finance, Economics, Accounting, or a related field; equivalent education and relevant experience may be considered.
Prior service operations experience.
Track record managing inventory and service operations metrics and reports, with process improvement experience.
Working knowledge of healthcare and/or insurance operations, products, policies, and procedures.

Responsibilities

Evaluate business processes and workflows to identify opportunities for operational improvement, efficiency, and cost reduction.
Lead process improvement initiatives using root cause analysis, technology assessments, and workflow optimization.
Manage projects that enhance processes and systems in partnership with IT, internal stakeholders, and external customers.
Maintain internal controls to ensure accurate and complete financial transactions and reporting.
Ensure compliance with applicable laws, regulations, policies, operational standards, and required training, reporting, accreditation, and regulatory requirements.
Manage departmental operating expenses, including salary and non-salary costs, within approved budgets.
Oversee collection activities, enforce collection policies, and manage delinquent accounts in accordance with legal and regulatory guidelines.
Lead, develop, and mentor supervisors and staff responsible for premium billing and collection functions.
Build relationships with brokers, sales teams, customers, and other stakeholders through effective communication and timely issue resolution.
Strengthen controls to prevent financial errors, revenue leakage, and material misstatements.
Represent the billing department in corporate projects and strategic initiatives, communicating business requirements.
Collaborate with stakeholders to resolve billing, payment, and customer service inquiries.
Ensure accurate monthly revenue reporting by reviewing, reconciling, and communicating premium collection activities to Finance.
Develop cross-functional partnerships and represent the premium billing department across the organization.
Partner with external vendors to monitor performance, review service level agreements and deliverables, and coordinate staffing requirements for enrollment and billing operations.
Oversee accounts receivable and invoice reconciliation, audit responses, payment posting and reallocation, premium collection, and manual and electronic enrollment.
Manage high-profile account delinquency and premium payment recoupment and collection.
Execute monthly, quarterly, and yearly revenue reports and partner with Finance on premium and general ledger tasks.
Manage month-end, quarterly, and year-end financial close for commercial and fully insured group accounts.
Oversee the yearly rate renewal process and quality controls for the Medigap population, as well as Medicare billing and premium rate validation.