Senior Associate, Billing Specialist

Responsibilities and Focus:

• Investigate and resolve escalated cases involving billing errors, benefit calculations, eligibility disputes, and insurance mismatches.
• Reconcile claims data and denial reports across multiple platforms to ensure accurate member statements and benefit balances.

Key Qualifications:

• Bachelor’s degree in Healthcare Administration, Finance, Business, or equivalent, with 3+ years in medical billing or escalation management.
• Deep understanding of claims lifecycle, benefits design, accumulations logic, and billing systems like EHRs.

Success Metrics and Team Collaboration:

• Achieve rapid, accurate escalation resolution while maintaining high member satisfaction and reducing billing inaccuracies.
• Collaborate cross-functionally with Operations, Product, Engineering, Support, Customer Success, Finance, Employers, and Payers.
• Proactively identify trends and implement process improvements to reduce recurrence and enhance workflows.