Lead Customer Billing Analyst

Job ID: J133027
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Oct 10, 2018

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Description

JOB SUMMARY

This position is responsible for the claims invoicing and accounts receivable activities for the ASO/ASC and Cost Plus customers including; managing various stages of the billing and accounts receivable cycle, creating analyses needed to support trends and billing comparisons that may span over months or years of billing activity, interpreting and communicating results of the analyses to management.  Assisting management with development of metrics used to measure productivity and quality, effectiveness of goals and compliance with existing controls.  Responsible to review existing processes to identify opportunities where process improvements, robotic solutions and/or rapid process acceleration enables overall labor or process cost reductions.

JOB DESCRIPTION

  • Research, review and analyze existing department processes and workflows to identify opportunities for process improvement and/or rapid process acceleration to support current and future streamling efforts. 
  • Act in a lead capacity and provide subject matter expertise during project meetings with enterprise wide stakeholders seeking complex and/or unique invoicing solutions to support the self-funded rated method for medium to large projects. 
  • Prepare and analyze billing and accounts receivable data and/or results to ensure compliance with policies, procedures and regulations. Use analysis to identify complex variances and explain variances to management. Analyze complex drug rebate pass through and PCPM variances and buy-up service requests (Cotiviti, Multi-Plan, Par-Wrap) and provide comprehensive reporting to internal and external constituents. 
  • Assist management with oversight of production related system issues during weekly billing and A/R cycles.  Assess and open necessary IT service tickets, participate in bi-weekly ticket prioritization discussions regarding production related risks and delivery of needed technology; perform end user testing as needed.  Ensure all policies and procedures are compliant based on system enhancements and/or project resdesign.
  • Assist with the investigation of SARA requests to determine validity of access need where department Director/Manager are data custodians. 
  • Prepare and respond to Requests for Proposal (RFP's) for New to Blue clients, in all market segments, for self-funded or integrated self-funded rating methods. Complexity of response varies based on client size and desired products. 
  • Other duties as assigned

EDUCATION

Required

  • High School/GED

Substitutions

  • None

Preferred

  • Bachelor's Degree in Finance or Business Administration/Management

Licenses or Certifications

  • None

EXPERIENCE

Minimum

  • 7 - 10 years General Business or Health Insurance Experience

To include:

  • 5 - 7 years Customer Billing, Quality Assurance or Data Analytics

Preferred

  • 7 - 10 years Finance and Accounting or Accounts Receivable

SKILLS

  • Analytical and Logical Reasoning/Thinking
  • Relationship-builder with Unsurpassed Interpersonal Skills
  • Written & Oral Presentation Skills
  • Self Starter
  • Customer Support
  • Data Analysis
  • Problem Solving & Decision Making
  • Oral & Written Communication Skills

Language: (Other than English)

None

Travel Requirement

0% to 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Does Not Apply

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

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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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