Dir Billing Operations (Administrative)

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.  If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. 

Director of Billing:

Ensure accurate and timely billing of all IBC premiums, self funded claims/capitation and administrative fees.  The scope of responsibility includes group fully insured and self funded billing arrangements, and the invoicing of individual and Medicare members. Oversee the application of payments, reconciliation of billed versus collected premiums, management of the delinquency and termination process, tracking of receivables and the collection efforts across the IBC Family of Companies.

 

Responsibilities:

1. Provide leadership to the management team and ensure that management metrics are in place to ensure effectiveness and efficiency in areas of responsibility.
   1. Develop, implement, review and monitor productivity metrics
   2. Develop, implement, review and monitor policies and procedures
   3. Ensure utilization of up-to-date technology and systems
   4. Manage resources to meet performance standards, while meeting the annual AOP, including vendor staffing and service providers
   5. Implement and manage service levels for our customers and members, as well as internal constituents
   6. Ensure proper training of all associates to ensure quality service to customers

 

1. Direct the management team responsible for the accurate and timely billing of all IBC premiums, self funded claims/capitation and administrative fees.
   1. Proper coordination with all other internal partners within the Family of Companies (including Enrollment, Finance, Claims, Customer Service, Sales and Marketing)
   2. Ensure refunds are evaluated for accuracy and issued according to service timelines

 

1. Direct the accurate and timely application of payments, the reconciliation of billed versus collected premiums/fees. Direct the reconciliation of enrollment transactions to premiums billed/paid on key accounts based on customer demands

 

1. Direct the identification and management of delinquent individual members, Medicare members and employer groups
   1. Ensure that the delinquency process is accurate and timely – per the corporate policies and procedures
   2. Timely and accurate cancellation of delinquent accounts according to corporate policy and Insurance department mandates
   3. Coordinate the transfer of serious delinquent receivables to outside collection agencies when appropriate. This includes contract negotiations with such agencies
   4. Represent IBC in legal actions requiring testimony pertaining to premium billings, payments and delinquency

 

1. Provide reporting to cross-functional teams and to senior management in order to improve collections timeliness and mitigate risk of non-collection 
   1. Provide monthly accounts receivable reporting for group, individual and Medicare receivables.  Reports will be provided to senior management
   2. Proper coordination with all other internal partners within the Family of Companies (including Enrollment, Finance, Claims, Customer Service, Sales and Marketing)

 

1. Perform other miscellaneous responsibilities deemed necessary for the proper running of the Billing and Collections department, including but not limited to:
   1. Ensure adherence to all SAS70 and Model Audit Rule key controls
   2. Ensure support of audits (internal and external) to support scope in timeframe required
   3. Support teams responsible for the transfer of billing/cash data to general ledger and rate renewal systems and processes as needed periodically
   4. Contribute to the prioritization of work and the management of internal resources (electronic billing, IS/BTS, Project Management, etc.)
   5. Customer requests regarding customized billing/payment requirements
   6. Continual analysis and upgrade or purchase of systems involving areas of accountability

 

·        BA/BS in Accounting, Finance, Business Administration, or other relevant discipline, or equivalent knowledge acquired by work experience and training.

·        Extensive Knowledge of Billing and Collections processes and systems, consolidated billing systems, and eBilling arrangements. Extensive Knowledge of the intricacies of the impact on billing relating to eligibility maintenance, pricing and contract maintenance. Working Knowledge of management and supervisory policies and practices. Demonstrated communication skills with both internal and external customers. Demonstrated ability to effectively work with functional departments outside of Finance. Demonstrated analytical, problem solving, and quantitative analytical skills. Ability to resolve issues and effect change. Working Knowledge of Microsoft Office Suite applications (Teams, Word, Excel, Outlook, and PowerPoint).

·        Ten (10) or more years of progressively more responsible experience in billing and collections, preferably in the healthcare insurance industry.

 

 

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

 

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.