Billing Operations Specialist

Overview

The organization is seeking a Billing Operations Specialist to support the configuration, administration, and ongoing maintenance of billing operations across multiple systems. This role ensures billing configuration accuracy, invoice generation, cash application, accounts receivable activities, reconciliation processes, and overall operational support.

Working closely with the Implementation, Billing, Finance, and Client Service teams, you will help ensure accurate group setup, invoice production, payment processing, issue resolution, and process improvement initiatives. This position serves as a cross-functional resource across billing and finance and supports special projects and evolving operational needs in a fast-paced environment.

Responsibilities

Billing Configuration & Maintenance

• Execute billing configuration setup and maintenance across multiple systems
• Build, maintain, and audit:
  • Group billing structures
  • Plan configurations and eligibility alignment
  • Rate tables and premium calculations
  • Vendor fee schedules
  • Payment arrangements and billing rules
• Enter and update:
  • Rates and plan changes (new business, renewals, mid-year updates)
  • Billing contacts and invoice recipients
  • Special billing arrangements and structures
• Support ACH setup and maintenance for client and vendor payment configurations
• Validate data accuracy and identify discrepancies prior to invoice generation
• Troubleshoot and resolve configuration-related issues impacting billing outputs

Invoicing & Accounts Receivable

• Support invoice generation and invoice audits to ensure billing accuracy
• Review and validate invoice data prior to release
• Monitor outstanding receivables and assist with collections activities
• Follow up with clients, brokers, and internal teams regarding outstanding invoices, billing discrepancies, and payment-related inquiries
• Research and resolve billing disputes and account discrepancies

Cash Application & Reconciliation

• Apply incoming payments accurately across billing systems
• Research unapplied cash, payment variances, and reconciliation discrepancies
• Assist with monthly and ad hoc reconciliation activities
• Reconcile invoice, payment, and adjustment activity across systems and reports
• Support audit requests and financial reporting needs by maintaining accurate records and documentation

Operational Support

• Follow established processes, controls, checklists, and documentation standards
• Identify process improvement opportunities and recommend operational efficiencies
• Assist with testing, system enhancements, and implementation of new billing functionality
• Maintain strong documentation of billing processes, configurations, and procedures
• Support special projects, process improvement initiatives, system implementations, testing activities, and other operational responsibilities as assigned
• Provide cross-functional support across billing, finance, and operations as business needs evolve

Qualifications

• 2–5+ years of experience in billing operations, accounts receivable, insurance operations, finance operations, or a related environment
• Experience working with billing systems, accounting systems, or administrative platforms
• Strong analytical and problem-solving skills
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment
• Excellent attention to detail and commitment to accuracy

Required Skills

• Advanced Excel skills, including VLOOKUP/XLOOKUP, pivot tables, data validation, filtering, and reconciliation of large datasets
• Strong system aptitude with the ability to navigate and work across multiple platforms simultaneously
• Experience configuring and maintaining billing, insurance, finance, or administrative systems, including setup of rates, plans, billing rules, payment structures, and related system parameters
• Experience performing data audits, reconciliations, and issue resolution
• Strong written and verbal communication skills
• Ability to communicate professionally with clients, brokers, vendors, and internal stakeholders
• Strong organizational and time management skills

Preferred Qualifications

• Experience in health insurance, employee benefits, TPA operations, premium billing, or related industries
• Experience supporting ACH payment processes and cash application activities
• Experience with system implementations, configuration management, or process improvement initiatives
• Familiarity with invoice generation, accounts receivable workflows, and reconciliation processes

Compensation & Benefits

No compensation or benefits information was provided.

Location

• Full-time, remote position aligned with U.S. business hours
• Flexibility required for critical project deadlines and cross-functional meetings
• Occasional travel (0–10%) for team collaboration or vendor engagements

Remote Work Requirements

• Dedicated home office with reliable, high-speed internet
• Secure workspace aligned with HIPAA security standards (device encryption, secure Wi-Fi, screen privacy)
• Ability to effectively coordinate and lead projects in a fully remote environment

Security, Privacy & Compliance

• Adherence to security and privacy policies, including HIPAA compliance
• Completion of security training and compliance with access management protocols

Physical Requirements

• Prolonged periods of sitting and working at a computer
• Ability to communicate effectively through video, phone, and written platforms
• Ability to effectively use computers, video conferencing tools, and other standard remote work technology
• Visual and auditory capabilities suitable for remote work
• Ability to occasionally lift up to 15 pounds

Tres Health is committed to ADA compliance and will provide reasonable accommodations to individuals as needed.

Employment Status

At-will employment: either the employee or the employer may end the employment relationship at any time, with or without cause or notice, as permitted by law.

EEO & Reasonable Accommodation

Equal Opportunity Employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other protected category. Reasonable accommodations are provided to enable individuals with disabilities to perform the essential functions of the role.

This description is not intended to list all duties or qualifications and may be updated at any time.