Overview
This remote position involves processing financial transactions within the organization's systems, including group and individual billing, Automated Clearing House (ACH) transactions, and cash receipt processing. The role requires maintaining and balancing group and individual accounts receivables, managing delinquency processing and terminations, handling receipt of group administrative fees, processing vendor payments, invoicing for third-party administrator (TPA) claims processing, and managing claims funding.
Responsibilities
- Maintain and manage contribution/premium reimbursements, COBRA/Retiree reimbursements, and vendor pass-through payments.
- Verify and authorize vendor payments within four business days of account funding.
- Manage funding and release of self-funded claims payments.
- Reconcile and maintain accuracy of group ledger accounts by matching payments to invoices, investigating discrepancies, collaborating with internal and external partners, and maintaining documentation.
- Monitor bank accounts daily for exceptions such as returned items, overdrafts, and stop payments; resolve or escalate as needed.
- Complete month-end financials by the fifth business day and assist with mid-month cash application audits.
- Manage bank lockbox, ACH/Wire programs, retiree invoicing, and receivable management.
- Support Flexible Spending Account (FSA), Health Savings Account (HSA), and Health Reimbursement Arrangement (HRA) programs.
- Manage delinquency processes for accounts.
- Oversee third-party pharmacy processes including reviewing claim data files, coordinating billing and invoicing, validating and auditing data files, and ensuring timely processing.
- Process and verify manual adjustments on group ledgers for various accounts.
- Perform bank reconciliations and initiate ledger adjustments.
- Verify and authorize refunds for terminations and overpayments.
- Apply cash to ledgers and research application issues.
- Provide backup support for invoice generation, daily cash application, and other accounting duties.
- Handle written and verbal account inquiries promptly.
- Prepare ad hoc reports as requested.
- Identify process inefficiencies and recommend improvements.
- Create and document Standard Operating Procedures (SOPs).
- Perform ledger reconciliations to ensure accuracy and compliance.
- Collaborate with Eligibility Specialists to resolve unpaid or outstanding balances.
- Act as liaison to other departments for issue resolution.
- Provide timely and effective customer service related to customer accounts.
- Represent the organization professionally in all interactions.
- Mentor junior Customer Accounting Specialists.
Requirements
- Bachelor’s degree in accounting, finance, business, or related field preferred, with 3 to 5 years of relevant experience or equivalent combination of education and experience.
- Ability to prioritize, multitask, work under pressure and deadlines, and work independently or in a team.
- Proficiency in Microsoft Excel (intermediate), Word, and Outlook.
- Experience performing customer account reconciliations and resolving discrepancies with minimal supervision.
- Excellent written and oral communication skills, including professional business correspondence and phone etiquette.
- Customer service orientation.
- Ability to analyze and resolve technical problems and client inquiries.
- Knowledge of healthcare eligibility and billing procedures, HIPAA, COBRA, Cal-COBRA, MEWA, and ERISA regulations.
- Understanding of the health insurance industry.
- Willingness to work overtime as needed.
- Reliable internet access with minimum 40 MB download and 10 MB upload speeds via cable or fiber.
- Home router with wired Ethernet connection (wireless and hotspots not permitted).
- Designated workspace ensuring confidentiality and security of company information.
- Functioning smoke detector, fire extinguisher, and first aid kit on site.
Physical Demands and Work Environment
- Regular communication with others.
- Frequent movement around the office.
- Use of tools, objects, and controls.
- Moderate noise level.
- Reasonable accommodations available for individuals with disabilities.
Compensation and Benefits
- Salary range: $53,667.86 to $74,768.32 annually.
- Rich benefits package including profit-sharing.
Location
- This is a remote position; candidates may reside anywhere in the United States.