Customer Billing Analyst

Company :

Job Description : 

JOB SUMMARY

This job is responsible for the claims invoicing and accounts receivable activities for the non-risk self-insured population of clients supporting all medical, buy-up, shared savings, drug, branded and non-branded dental, and spending account products.  The client population will include a portfolio of higher volume and more complex structure and reporting.  Provides guidance and mentoring to other analyst's with less experience.   The incumbent will create and maintain customer accounts by auditing all changes in the system that will impact the billing and/or accounts receivable activity for the self-funded customer base; review and analyze weekly management/trending reports; run (SQL) queries based on customer specific needs; reconcile and analyze payment activity for self-billed administrative clients to ensure compliance with audit thresholds; must be able to interact well with a cross-functional set of internal stakeholders (Sales, Information Technology, Management, Finance/Accounting, Underwriting) as well as external stakeholders; must be able to work in a fast-paced environment with daily work processing deadlines; and follow all HIPAA and HITECH guidelines pertaining to Protected Health Information (PHI).

ESSENTIAL RESPONSIBILITIES

• Perform billing, A/R and reporting functions to support self funded customers including; ensure timeliness and accuracy of invoices using reasonableness and/or comparative assessments and judgment for a specific customer portfolio, utilize trending reports to validate completeness and data integrity associated to the invoice and A/R cycle; ensure all rate discrepancies, self billed administrative,  and payment allocation reconciliations are prepared, finalized and executed in a timely manner to support the weekly billing cycle; monitor customer receivables and coordinate collection efforts; maintain customer profiles, create and maintain electronic user access.  Propose automation solutions to manual tasks and make recommendations to enhance efficiency around current processes.  Providing guidance and mentoring to other analyst's with less experience.
• Responsible for daily interaction with sales personnel.  Able to work independently to respond and resolve inquiries from internal and external customers, brokers, agents or consultants.
• Create custom ad hoc reporting ensuring accuracy, upon varying intervals, to support client or sales specific inquiries; manage system and ad hoc reports that include proprietary, confidential and Protected Health Information while maintaining all compliance requirements.
• Required to participate in special projects or activities identified by management.
• Other duties as assigned.

EDUCATION

Required

• High School/GED

Substitutions

• None

Preferred

• Bachelor's degree

EXPERIENCE

Required

• 3 years of relevant subject matter experience in the area of specialization

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Must interact well with a cross-functional group of internal and external stakeholders such as; Sales, System Support, Management, Finance/Accounting, Underwriting and Clients.
• Must be able to work in a fast-paced environment with daily work processing deadlines
• Demonstrate personal accountability
• Ability to develop specific skills and knowledge of a billing and/or AR subject matter expert
• Ability to think strategically and act proactively under pressure independently and as a part of a team
• Strong innovative problem-solving capabilities
• Proficiency with Microsoft Office products (i.e. Word, Excel, Powerpoint, Outlook etc.)

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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