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Billing and Research Specialist III


Posted: 10/2/2019
Job Reference #: 5000329075406

Job Description

Employment Type


Exempt or Non-Exempt


Job Summary

The MS Billing & Research Specialist III is responsible for independently resolving any member or group billing reconciliation inquiries and protecting HMSA's reputation by ensuring the accuracy of monthly premium billing.

The MS Billing & Research Specialist III will represent the unit through internal and external engagements to enhance the customer experience through education and improvements.

Minimum Qualifications

  1. Bachelor's degree; or equivalent combination of education and experience.
  2. Strong accounting skills.
  3. Self-motivated and directed; ability to work independently with minimal supervision.
  4. Effective 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.


Duties and Responsibilities

  1. Display business knowledge required to independently research any member billing issue and complex group billing issues; 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. Conducts research as requested by management for sensitive cases/situations.
  2. Represents the unit at inter- and intra-departmental engagements including but not limited to cross-functional continuous improvement initiatives. Represents HMSA at external engagements to understand a group's business issue related to billing, providing education and/or recommending improvements to resolve the issue.
  3. 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.
  4. Perform other duties as assigned.