Billing Specialist

Position Summary

Unified Health Plan is seeking a detail-oriented Billing Specialist to support the financial operations of our self-funded and level-funded health plan administration business. This role is responsible for premium billing, administrative fee billing, reconciliation of employer group accounts, vendor payment coordination, and ensuring accurate and timely invoicing across multiple clients and funding arrangements.

The ideal candidate has strong accounting fundamentals, excellent organizational skills, and the ability to work in a fast-paced environment while maintaining accuracy and professionalism.

Key Responsibilities

Premium Billing & Client Invoicing

• Generate monthly premium invoices for employer groups across ASO, level-funded, and other health plan arrangements.
  
• Review census changes, eligibility updates, plan changes, and rate changes to ensure billing accuracy.
  
• Process billing adjustments including retroactive adds, terminations, COBRA adjustments, and dependent changes.
  
• Coordinate billing setup for new client implementations.
  

Account Reconciliation

• Reconcile employer group billing accounts monthly.
  
• Research billing discrepancies, payment variances, and eligibility mismatches.
  
• Reconcile premiums, administrative fees, network access fees, care management fees, and other applicable charges.
  
• Maintain accurate billing records and audit trails.
  

Accounts Receivable & Collections

• Monitor accounts receivable aging reports.
  
• Follow up on past-due balances with employer groups, brokers, or internal account managers.
  
• Coordinate payment plans or resolution of disputed invoices when necessary.
  
• Document collection activity and account status.
  

Vendor & Funding Coordination

• Coordinate billing and payment activity with key vendors such as utilization management, telehealth, PBM, network access, and other plan vendors.
  
• Verify vendor invoices align with contracted rates and enrolled member counts.
  
• Support funding reconciliation related to claims accounts and administrative accounts.
  

Reporting & Compliance

• Prepare billing reports, aging reports, and financial summaries for leadership.
  
• Maintain billing documentation in accordance with internal controls and audit requirements.
  
• Support year-end reporting, client audits, and finance department requests.
  
• Assist with compliance related to billing accuracy and financial controls.

Requirements

• 2 years of experience in billing, accounts receivable, accounting, or finance.
  
• Strong proficiency with Microsoft Excel.
  
• Experience with account reconciliation.
  
• Strong mathematical and analytical skills.
  
• Excellent attention to detail and organizational skills.
  
• Strong written and verbal communication skills.

Benefits

Health & Insurance Benefits

• Medical Insurance
  
• Dental Insurance
  
• Vision Insurance
  
• Employer-Paid Life Insurance
  
• Employee Assistance Program (EAP)
  
• Telehealth Services
  

Retirement Benefits

• 401(k) Plan
  
• Employer 401(k) Contribution (7% employer contribution)
  

Paid Time Off

• Paid Time Off (PTO)
  
• Paid Holidays