Company :
Highmark Inc.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. This job 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 basic (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).
EDUCATION
- 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.
- Responsible for daily interaction with sales personnel. Respond to and resolve inquiries from internal and external customers, brokers, agents or consultants.
- Create custom ad hoc reporting, 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.
- May be required to participate in special projects or activities identified by management.
- Other duties as assigned.
EDUCATION
Required
- High School Diploma/GED
Substitutions
- None
Preferred
- Bachelor's degree
EXPERIENCE
Required
- 1 year subject matter experience in the area of specialization
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 Requirement:
None
Travel Requirement:
0% - 25%
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:
$20.72Pay Range Maximum:
$30.12Base 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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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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