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Billing and Research Specialist I


Posted: 10/2/2019
Job Reference #: 5000329092306

Job Description

Employment Type


Exempt or Non-Exempt


Job Summary

To enhance customer experience and protect HMSA's reputation by ensuring the accuracy of monthly premium billing and providing research support to the Membership Department.

The MS Billing & Research Specialist I is responsible for resolving billing reconciliation inquiries and requests from employer groups and members, performing functions necessary to fulfill these requests including balancing and reconciling eligibility and dues payments.

Minimum Qualifications

  1. Associate's degree or equivalent combination of education and relevant experience.
  2. Strong accounting skills or equivalent.
  3. Self-motivated and directed; ability to work independently with minimal supervision.
  4. Good written and verbal communication skills to explain reason and resolution for billing issues.
  5. Analytical and problem solving skills.
  6. Experienced in using Microsoft Office programs such as Word and Excel.

Duties and Responsibilities

  1. Research routine to moderately complex billing issues identified by employer groups or members; effectively communicate (written, telephonically or in person) the outcome of the research and resolution to the issue in a timely manner. Ensure appropriate approval levels are satisfied. Adhere to all audit and compliance policies and procedures.
  2. Analyze discrepancy reports as a result of billing or payment application differences between multiple systems. Perform updates as needed or coordinate with other units/departments to resolve the discrepancy. Identify system or process improvements for recommendation.
  3. Provide research and maintenance support to the department as assigned; coordinating related efforts to ensure resolution in a timely and accurate manner.
  4. Perform other duties as assigned.