Premium Billing Specialist

Medicare Advantage Health Plan Miramar, Florida


Description

Position at Clear Spring Health

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture. Group1001’s culture emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets – our employees.

Company Overview

Clear Spring Health is part of Group One Thousand One (“Group1001”), a customer-centric insurance group whose mission is to make insurance more useful, intuitive and accessible so that everyone feels empowered to achieve financial security. Clear Spring Health is dedicated to helping seniors protect their health and well-being by providing Medicare Advantage plans in select counties of Colorado, Illinois, North Carolina, and Virginia, plus Georgia and South Carolina through our affiliate, Eon Health (redirects to Eon).

Group1001 is on a mission to empower consumers. Our family of companies share a common goal: giving people more control over their money, making it easier for them to do businesses with us, and creating more opportunities for them to see value every day.

Group1001 is a consumer-centric, technology-driven family of insurance companies on a mission to deliver outstanding value and operational performance by combining financial strength and stability with deep insurance expertise and a can-do culture.

One of the goals for Group1001 is to foster a great culture.  Group1001 will continue to build a culture that emphasizes the importance of collaboration, communication, core business focus, risk management, and striving for outcomes. This goal extends to how we hire and onboard our most valuable assets, employees. 

Job Summary

Under the supervision and direction of the Manager of Billing Services, the Premium Billing Specialist is responsible for the accurate invoice generation and posting of payments to support the billing unit while meeting applicable Medicare regulations.

 Main Accountabilities

  • Day to day work of billing queues
  • Performs premium billing reconciliation and resolves discrepancies in a timely manner.
  • Processes monthly premium billing operations in a timely manner in accordance with the billing calendar. These operations include but are not limited to invoice processing, lockbox and ACH operations, import/ export of premium related files from the membership system, file error resolution, and refund processing.
  • Maintains required billing records, reports, and files.
  • Participates in meetings with Management to inform and discuss premium billing operations.
  • Conduct audits and reviews when applicable and submit in a timely basis.
  • Assist with premium billing member complaints.
  • Participate in internal and external premium billing and/or financial audits.
  • Assists with other duties as assigned.

 Qualifications:

  • A minimum of 1-3 Years of billing experience a plus
  • Knowledge of Medicare or Commercial Insurance products and services
  • Strong verbal and written communication skills
  • Proven decision-making skills and ability/willingness to multi-task in a fast-paced environment
  • Strong organizational and time-management skills
  • Ability to multi-task, good organizational and time management skills.
  • Analytical skills in research and problem resolution.
  • Analytical ability with an affinity to detail, as well as the capability to handle heavy workloads and meet deadlines.
  • Must be able to work and act independently and be self-directed.
  • Associates degree or equivalent experience preferred