Billing Specialist

Position Overview

The Billing Specialist will provide dedicated ownership and oversight of billing administration for the Supplemental Health Solutions block of business, with a focus on accurate invoicing, timely premium collection, discrepancy resolution, and strong customer support. This position will serve as a key billing resource for group customers, brokers, Sales/Account Management, Customer Service, Remittance, and other internal partners, ensuring billing questions and issues are addressed with consistency, urgency, and professionalism. As SHS enrollment and customer volume continue to grow, the Billing Specialist will help strengthen operational accountability by managing List Bill and Self-billing processes, identifying and resolving premium and remittance discrepancies, supporting eligibility updates when needed, and proactively monitoring billing activity to reduce errors, prevent escalations, and support a positive customer experience.

Essential Elements

• Invoicing & Premium Collection (30%) Conducts proactive outreach to group customers regarding payment discrepancies, misdirected payments, cash received without backup, missing remits, missing payments, and overpayments. Offers situation-specific alternatives and solutions to assist customers. Generates and distributes List Bill invoices for assigned group customers on a monthly billing cycle. Manages Self-billing reconciliation when premium received does not match the remittance file or when premium does not align with enrollment in VBA.
• Billing Accuracy & Discrepancy Resolution (25%) Performs functions critical to the accuracy of billing for assigned group customers including daily review and analysis of error reports; suspense management; billing vs remit discrepancies; billing master schedule updates; final bill hold review and release; eligibility updates and identification and resolution of D&U. Proactively monitors billing transmission and payment processes for the Supplemental Health Solutions block to prevent billing issues and avoid escalations.
• Reconciliation & Cash Allocation (20%) Completes group level reconciliations and payment history review. Determines appropriate cash allocation and provides direction to the Remittance Department for proper premium application. Makes decisions regarding refunds, write-offs, and reinstatements.
• Customer & Partner Communication (15%) Builds and maintains strong relationships with group customers and internal partners. Serves as key contact to internal partners on issues, working effectively with internal and external contacts in problem resolution. Resolves and responds directly to group customers regarding billing inquiries and issues. Participates in escalation calls as billing expert with Customer, Broker, Sales/Account Management, and Customer Service as situation warrants.
• Customer Education & Onboarding Support (10%) Educates customers on the billing and remittance processes and provides ongoing guidance and support during implementation and welcome call, as well as throughout the entire customer relationship to make billing administration easy for our customers and internal partners.

Requirements

Education and Certifications

Required:

• Associate's degree in Business, Accounting, Finance, or related field; OR equivalent combination of education and work experience

Preferred:

• Bachelor's degree in Business Administration, Accounting, Finance, Insurance, or related field
• LOMA ACS (Associate, Customer Service) or FLMI designation
• AHIP Health Insurance Associate (HIA)
• CEBS (Certified Employee Benefit Specialist) or progress toward

Experience

Required:

• 2–4 years of experience in billing, premium accounting, invoicing, accounts receivable, or related financial operations within the insurance, health plan, or TPA industry
• Demonstrated experience with group billing processes (List Bill and/or Self-billing)
• Experience resolving billing discrepancies, premium variances, and customer payment issues
• Proficiency with Microsoft Office Suite, especially Excel (pivot tables, VLOOKUP, reconciliation)

Preferred:

• Experience with policy administration and billing systems
• Knowledge of supplemental health products (accident, critical illness, hospital indemnity)
• Experience working with BCBS Plans, brokers, or group enrollment platforms
• Familiarity with remittance processing, cash allocation, and eligibility administration
• Prior experience supporting customer onboarding or implementation from a billing perspective

Travel Required

Minimal travel required. Some travel may be necessary for customer onboarding, training, or team meetings.