Senior Associate, Billing Specialist

Overview

A leading virtual healthcare provider specializing in women's and family health is seeking a Senior Associate, Billing Specialist. This role focuses on resolving complex financial and benefits billing escalations to ensure accurate member financial tracking and equitable solutions for members, employers, and insurers.

Responsibilities

• Investigate and resolve escalated billing cases including errors, incorrect benefit calculations, eligibility disputes, overpayments, insurance reviews, and balance mismatches.
• Perform root-cause analysis on multi-system issues such as billing delays, data reconciliation, and error tracking.
• Coordinate corrective actions like claim adjustments, accumulator adjustments, or balance reconciliations with internal and external partners.
• Serve as the primary liaison between Operations, Product and Engineering, Support, Customer Success, Finance, Employers, and Payers to clarify issues and expedite resolutions.
• Reconcile claims data, denial reports, and financial outputs across multiple platforms to ensure accurate benefit balances and member statements.
• Maintain detailed documentation of issues and track cases through to resolution.
• Identify trends in escalations and propose systematic process improvements to reduce recurrence.
• Communicate clearly and compassionately with members and stakeholders regarding resolution steps, outcomes, and next actions.

Success Metrics

• Timely and accurate resolution of escalations with high member satisfaction.
• Reduction in billing inaccuracies and escalation volume over time.
• Data-driven improvements in escalation workflows and reduction of systemic issues.

Qualifications

Educational & Professional Background

• Bachelor’s degree in Healthcare Administration, Finance, Business, or related field preferred, or equivalent experience.
• Minimum 3 years of relevant experience in medical billing, health benefits, or escalation management.

Technical & Domain Knowledge

• Proven experience handling complex billing escalations such as accumulator discrepancies, eligibility issues, overpayments, and billing corrections.
• Strong understanding of claims lifecycle, benefits design, accumulations logic, accounts receivable workflows, and insurance adjudication.
• Familiarity with billing systems (EHRs, clearinghouses), issue tracking tools (e.g., Zendesk, Jira), and data/reporting platforms (e.g., Google Sheets, Looker).

Analytical & Problem-Solving Skills

• Highly detail-oriented and organized.
• Strong critical-thinking skills for root-cause analysis and resolving multi-stakeholder issues.

Communication & Collaboration

• Excellent verbal and written communication skills, able to translate billing data into clear recovery plans.
• Experience collaborating cross-functionally with member services, care teams, finance, employers, providers, and insurers.

Soft Skills & Adaptability

• Empathetic and member-centric approach to handling escalated cases.
• Comfortable adapting to shifting priorities in a fast-paced environment.
• Creative problem-solver with resourcefulness to develop innovative escalation strategies.

Compensation & Benefits

• Base salary range: $98,000 - $107,000 per year.
• Eligibility for equity and benefits.
• Benefits include employer-covered health, dental, and insurance plans.
• Access to comprehensive care platform including mental health, reproductive health, family planning, and pediatrics.
• Wellness partnerships and whole-self care support.
• Hybrid work model with in-office meals and scheduled collaboration days.
• 16 weeks of 100% paid parental leave and new parent stipend (after 1 year of employment).
• Annual professional development stipend and access to a personal career coach.
• 401(k) matching with immediate vesting for US-based employees.

Location & Work Model

• This role requires active work authorization in the US.
• Flexible hybrid work model primarily based in the New York Metropolitan area, San Francisco/Bay Area, or Seattle.
• New York City office employees are expected onsite three days per week (Tuesday, Wednesday, Thursday).
• Employees in San Francisco/Bay Area or Seattle attend quarterly in-person collaboration days.
• Remote candidates are welcome from AZ, CA, CO, CT, DC, DE, FL, GA, HI, IL, IN, KS, MA, MD, ME, MI, MN, MO, NC, NH, NJ, NM, NV, NY, OH, OR, PA, RI, SC, TN, UT, VA, VT, WA, WI.

Equal Opportunity

The employer is an affirmative action and equal opportunity organization. All qualified applicants will receive consideration without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Reasonable accommodations are provided for individuals with disabilities in employment and related activities.