Hunter Hamilton

Billing Reconciliation Specialist

Minnetonka, MN
Sep 06, 2018
Oct 06, 2018
Hunter Hamilton
Job Type
Employment Status
Full Time

Hunter Hamilton is seeking Billing Reconciliation Specialists for a growing medical company in the N. Metro on a long term, temporary basis. If you are available immediately, apply now! The Billing Reconciliation Specialist is responsible for creating invoices, credit memos, tracking receipts and payments for policyholders and vendors as directed, and maintaining policyholder and vendor records as necessary to ensure the effective, efficient and accurate financial and administrative operations. 

Accounts Receivable/Accounts Payable Reconciliation - 30%
• Resolves outstanding aging balances for accounts, using knowledge of business systems and their relationship to contract analysis and invoicing
• Reconciles cash and credit card receipts against bank deposits
• Continuously follows-up including, but not limited to, elevation and escalation to management for those accounts that may move into the delinquent category, resulting in Grace letter adjudication 
and/or policy termination
• Reconciles the Daily Cash worksheet in conjunction with the Finance department 
• Maintains all business unit specific accounts payable reports, accounts receivable aging, and other cash flow spreadsheets

Accounting and Reporting - 25%
• Is responsible for all billing related tasks, including invoicing, monthly statements, and Accounts Receivable management and reporting
• Is responsible for all Accounts Payable, including processing of refunds on time and reconciling to vendors acting as TPAs
• Prepares and delivers ACH file to bank that facilitates accurate and timely drafts of policyholder back accounts
• Assists in monthly closing process – primarily as it relates to preparing required reports to facilitate carious accounts receivable and account payable journal entries
• Presents administrative expense invoices to management and obtains necessary approvals / signatures for payment

Customer Support - 20%
• Reviews and responds to questions regarding open or closed balances
• Assists Customer Service, Broker Services, & other units of IFB Operations with investigating billing inquiries to ensure polices are up to date; explains billing processing and timeliness to interested 
• Researches escalated billing inquiries, both on and off exchange for Appeals, Regulatory, and member complaint submissions
• Assists the Enrollment & Eligibility Specialist team in processing ACH enrollments & payments as needed 
• Serves as subject matter expert to internal and external business partners 

Compliance Obligations, Regulatory Compliance - 15%
• Obtains and maintains current knowledge of contractual obligations from CMS, MNsure, and Medica policy to ensure compliance of Medica’s Individual billing processes 
• Initiates member correspondence as appropriate and regulated by CMS Guidance on policy updates, cancellations, terminations
• Monitors daily activities and transactions to ensure compliance with state and government regulatory requirements
• Maintains a high level of accuracy in account adjustments
• Ensure the confidentiality, integrity, and security of all financial files

Training and Process Improvement - 10%
• Assists in maintaining and updating Billing and Reconciliation processes, procedures, and training documents
• Provides consultation and explanation to IFB’s internal partners regarding billing and reconciliation processing operations and timelines
• Identifies broker training needs (or inside sales training needs), as well as needed communications enhancements
• Supports the training and mentoring of internal staff on billing processes as needed
• Identifies and recommends process improvements and works with the Call Center, Medica IT, Enrollment, Claims, and vendors to implement enhancements

Minimum education level required to qualify for the position: Bachelor’s degree or equivalent experience
Minimum years’ experience required in the field to qualify for the position: 1 year

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