Temporary Premium Billing Reconciliation Specialist I

Martin's Point Health Care • Portland, ME

1d

About The Position

The Premium Billing Reconciliation Specialist role supports the accuracy and integrity of billing data by overseeing the day-to-day operational activities of member profile management and health plan data reconciliation. This position ensures compliance with all policies, procedures, and regulations related to Medicare, DOD and the Bureau of Insurance enrollment billing and payment data reconciliation.

Requirements

• High School Diploma required.
• 2+ years of health plan membership enrollment and/or billing processing experience.
• Experience with plan enrollment and supporting systems.
• Experience working with Managed Care eligibility processes and systems, preferably with Government health care programs.
• Exceptional analytical skills.
• Proficient knowledge of Microsoft Excel is required.
• Must have excellent communication skills as this position interacts with individuals outside the organization.
• Detail oriented with excellent follow up skills
• Demonstrates an understanding of and alignment with Martin’s Point Values.
• Must be detail and deadline oriented, flexible, and able to function effectively in a fast-paced environment.
• Must be able to work a flexible schedule, including weekends and holidays when necessary

Nice To Haves

• Post-Secondary Education preferred.

Responsibilities

• Maintains expertise in premium billing knowledge.
• Serves as a learning resource within team and other area departments related to basic and complex premium payment processing.
• Works collaboratively within the Accounting and Finance team to ensure timely response to member premium related requests, inquiries and issues.
• Consistently meets or exceeds department accuracy and productivity goals.
• Identifies process and workflow gaps, manages process improvement activities to resolve opportunities.
• Assists Supervisor in developing and distributing standard work and ad hoc reports
• Maintains skillset and support for all listed Premium Billing Specialist tasks to cover and provide support as needed
• Performs quality assurance reviews on the reporting and data to identify trending issues and opportunities for resolution
• Performs entry level oversight of reporting reconciliation and data validation to include daily, weekly and monthly billing
• Supports compliance and audit activities, including compilation of documentation requested by internal and external auditors as well as development of corrective action plans.
• Will also assist in the implementation of any corrective action plans
• Manages account investigation and quality assurance of data found in the premium billing system.
• Processes member premium refunds and corrections as needed
• Resolves escalated premium related inquiries from members, external customers and key stakeholders
• Responsible for daily payment posting, upload or electronic payment processes and applications.
• Responsible for management and maintenance of special payment options
• Identifies system and process defects and provides recommendations for solutions.
• Partners with the Premium Billing Specialist II to manage the status and accuracy of overdue or underpaid accounts.
• Generates and manages member invoices as request by members and other key stakeholders.
• Performs other related duties as assigned
• Ensures timely and compliant billing of members.
• Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.

Benefits

• Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day.
• certified as a "Great Place to Work" since 2015.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED