Mgr, Traditional Billing

Horizon Blue Cross Blue Shield of New Jersey•Newark, NJ

11d•$109,600 - $149,625

About The Position

The Manager, Traditional Billing oversees multiple billing and enrollment teams to ensure timely, accurate billing and enrollment completion and proper revenue reporting. The role manages accounts receivable and invoice reconciliation, internal and external regulatory audits, payment posting reallocation, premium collection, and manual and electronic enrollment. It also handles high-profile account delinquency and premium recovery. The manager prepares monthly, quarterly, and annual revenue reports and partners with Finance on premium and general ledger activities, including month-end, quarterly, and year-end financial close for commercial and fully insured group accounts. The role is accountable for annual rate renewal and quality controls for the Medigap population, oversees Medicare billing and premium rate validation, and manages commercial-market revenue and premium collection for a business with annual revenue exceeding $4 billion. The position drives operational improvement, controls, regulatory compliance, budget management, and vendor performance across billing and enrollment operations. It leads and develops supervisors and staff, represents the department in corporate initiatives, and works with internal and external partners to resolve billing, payment, and customer service issues.

Requirements

High school diploma or GED required.
At least five years of managerial experience required.
At least 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.
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 verbal and written communication skills and ability to influence stakeholders at all organizational levels.
Strong analytical and quantitative skills, including the ability to interpret data, identify trends, and develop actionable solutions.
Ability to manage multiple priorities in a fast-paced, high-volume environment.
Relationship management, collaboration, negotiation, and conflict resolution skills.
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 effective business solutions.
Strong organizational skills and exceptional attention to detail and accuracy.
Proficiency in Microsoft Office applications and business reporting tools.

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.
Experience leveraging emerging technologies, including Artificial Intelligence and Machine Learning, to improve operational efficiency, automate workflows, and improve billing outcomes.
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 to enhance processes and systems in partnership with IT, internal stakeholders, and external customers.
Maintain and strengthen internal controls to ensure accurate and complete financial transactions and reporting and to prevent financial errors, revenue leakage, and material misstatements.
Ensure compliance with applicable laws, regulations, policies, operational standards, training, reporting, accreditation, and regulatory requirements.
Manage departmental salary and non-salary operating expenses 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.
Represent the billing department in corporate projects and strategic initiatives, communicating business requirements and ensuring they are addressed.
Collaborate with internal and external stakeholders to resolve billing, payment, and customer service inquiries.
Review and reconcile premium collection activity and communicate it to Finance to support accurate monthly revenue reporting.
Develop cross-functional business partnerships and represent the premium billing department across the organization.
Partner with external vendors to monitor performance, review service level agreements, evaluate deliverables, and coordinate staffing requirements for enrollment and billing operations.
Manage accounts receivable and invoice reconciliation, audits, payment posting reallocation, premium collection, manual and electronic enrollment, and delinquent accounts.
Prepare monthly, quarterly, and annual revenue reports and partner with Finance on premium, general ledger, and financial close activities.
Oversee annual rate renewal and quality controls for Medigap, as well as Medicare billing and premium rate validation.