Billing Representative

COBRA Billing And Collections Specialist

Under the direct supervision of the Billing Manager, performs duties related to the billing, collection, and reconciliation of group and individual premiums and the administration of Consolidated Omnibus Budget Reconciliation Act (COBRA) services in adherence to current law and regulations. Analyzes, researches and resolves customer issues. Assists Billing Manager in ensuring company and departmental goals and objectives are met and work processes are in compliance with current departmental practices and policies.

Essential Duties And Responsibilities

• Interprets and applies complex COBRA regulations to administer COBRA services for groups. Provides support and guidance on COBRA compliance to group administrators. Responsible for the timely and accurate processing of the following primary functions: enrollments and eligibility updates, cash receipts posting and reconciliation, and notifications and refunds. Ensures the synchronization of eligibility data between the external COBRA software and HDS's system.
• Responds to phone and email inquiries regarding COBRA, Groups, and Individual Dental Plan (IDP), related to enrollments, invoices, and payments.
• Collects delinquent premiums from employer groups with professionalism and sensitivity. Determines the appropriate approach, monitors payments and documents collection efforts and discussions regarding payment status. Prepares collection letters. Uses judgment to advise groups of potential consequences of further non-payment and notifies management of accounts at risk.
• Provides internal and external customer service assistance utilizing a comprehensive understanding of HDS policies and practices related to billing, COBRA, Individual Dental Plans, eligibility, and contracts. Actively listens to customers, interprets needs, and determines the course of action. Conducts research to resolve customer issues quickly and effectively. Processes IDP credit card transactions by phone.
• Processes the incoming mail, as well as the mailing of COBRA & IDP notifications and group invoices using controls to reduce the potential for breaches.
• Reconciles and monitors group payments by using records gathered from multiple sources to ensure appropriate payments are received in relation to billing and eligibility. Uses a comprehensive understanding of diverse billing formats, complex funding arrangements, and the interrelationship of eligibility, contract, and billing/accounting systems. Conducts research and works with groups or other internal departments to determine appropriate actions needed to resolve payment, billing, or eligibility issues.
• Other Duties & Responsibilities
  1. Promotes and assists group administrators with HDS Online services for Employer Groups. Educates on system advantages and supports users on system capabilities. Provides feedback to management on online system issues and the need for enhancements.
  2. Provides administrative support, such as filing and scanning of Billing, COBRA & IDP documents for electronic filing and records retention.
  3. Identifies opportunities to increase operational effectiveness and efficiency of the department and increase the value of HDS products.
  4. Other miscellaneous duties and responsibilities as assigned.

Minimum Qualifications And Experience

Education

• High school diploma or equivalent required.
• College coursework in accounting, bookkeeping, business administration, finance, or a related field preferred.

Experience

• Two (2) years of experience in customer service, billing, accounts receivable, collections, cash handling, payment processing, enrollment administration, or a related administrative support role preferred.
• Relevant work experience may be substituted for post-secondary education.
• Experience in healthcare, insurance, employee benefits, COBRA administration, or a related industry is preferred.
• Typing proficiency of at least 40 words per minute with a high degree of accuracy required.
• Proficiency using a 10-key calculator by touch required.

Skills and Knowledge :

• Analytical skills, including the ability to define problems, collect and organize data, analyze, and understand various sources of information and problem-solve complex problems.
• Ability to learn, thoroughly comprehend, and communicate COBRA regulations and related HDS policies.
• Requires continuously finding new and better ways of performing the job, seeking solutions, and exercising good judgment.
• Requires organization and ability to manage multiple tasks and maintain focus with attention to detail.
• Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI).
• Working knowledge of PC applications (Windows, Word and Excel) is highly desirable.

Work Environment

• Hybrid part time in the office and part-time at home. During the orientation period, it may be required to work 100% in the office, until successfully completing the orientation period. Additionally, depending on the business needs, there may be periods where it will be a requirement to work in the office.
• Monday - Friday, weekend and holiday work may be required.

Note : The above information in this description has been designed to indicate the general nature and level of work performed by an employee in this classification. It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job. Hawaii Dental Service has the right to add to, revise, or delete information in this description. Reasonable accommodations will be made to enable qualified individuals with disabilities to perform the essential functions of this position.