Sr Billing Consultant

in Sunrise, FL

Sr Billing Consultant Job

Job Description Job Attributes+

  • Job ID

    987880-3

  • Req #

    73290BR

  • Job Location

    Sunrise, FL, US

  • Job Category

    Aetna

  • Job Type

    Full Time

Job Description
Sr. Billing Consultant is responsible to ensure dues are finalized and money is collected and allocated across benefits and structure. Work to improve financial results by reducing losses associated with non-payment. Act as a subject matter expert for internal and external constituents.  Deliver consultative and professional services to our clients by preparing and delivering an accurate invoice, collecting and posting payments timely, reconciling payments, reporting and resolving discrepancies.  Responsible for providing timely responses on financial reports on a monthly basis.

Fundamental Components

  • Reviews Plan Sponsor member listings, Plan Sponsor (or individual member) payments, and/or terminations and compares to actual billing statement to identify and resolve discrepancies.
  • Monitors, researches, and resolves collection of outstanding premium or revenue adjustment issues and reports corrections to appropriate contact; Resolution activity related to delinquent accounts may involve verbal and/or written communications with customers and other key internal business areas.
  • Ensures all manual adjustments, refunds, and write-offs are appropriately submitted, adhering to policy guidelines. Validates and updates Self Insured Revenue forecasting information and trends.
  • Coordinates validation of eligibility on fully insured and/or self-insured customers.
  • Applies technical policy, legislation, Plan Sponsor account structure and benefit information to decisions.
  • Codes rates and structure on new cases and renewals/revisions, in system to provide customer with accurate and timely invoices and to send data to downstream systems.
  • Ensures that remittances are posted accurately across various benefits and account structure and reconciles customer remittances; Related activities may include negotiating payment schedules and settlements.
  • Identifies and determines appropriate treatment of overdue accounts and coordinates collection and cancellation of overdue customers in accordance with pre-established market segment process.
  • Consults with internal/external customers to identify accurate account structure, billing format method and payment arrangements to meet customer expectations.
  • May serve or provide technical SME support to the team/unit.
  • Provides assistance and/or mentor internal and external constituents.
  • Reviews Non-Admit reports to ensure that Plan Sponsor’s balances are within statutory guidelines.
  • Identifies electronic media prospects as it relates to premium payment back up and routinely contact and follow up with potential electronic candidates and finalizes electronic workflows with Plan Sponsor and/or vendor.
  • Communicates and negotiates with Fortune 500 customers for prompt and accurate payment of amounts due.
  • Researches, resolves and responds to billing inquiries/member issues generated from Plan Sponsor, third party vendor, Member Services or marketing office. Answers questions and resolves issues based on phone calls/letters from Plan Sponsors and internal constituents.



Background Experience

  • Financial/Accounting experience a plus. 
  • Must be able to work independently as well as in a team environment. 
  • Able to multi-task and problem solve. 
  • Good listener with the ability and confidence to interact effectively with both internal and external contacts.  Attention to detail, excellent verbal and written communication as well as analytical skills preferred. 
  • Proficiency in Microsoft excel ex: V-loopup & Pivot tables.



Additional Job Information
Ability to analyze financial information and reports.Ability to prioritize tasks/work effectively.Strong verbal and written communication skills.Strong organization skills.Math and accounting skills.Problem solving skills.Attention to detail and accuracy.

Education
Bachelor's degree or equivalent experience

Percent of Travel Required
0 - 10%

Additional Information

Who We Are

We’re a values-based organization focused on helping people on their path to better health. Here, you’ll work alongside former members of the military and current reservists and members of the National Guard. Bring your unique skills to our industry, and we look forward to helping you grow your career.

We offer opportunities at all levels for U.S. Veterans and will enforce the Uniformed Service Employment and Reemployment Rights Act (USERRA).

Also, if you’re a Reservist member of the National Guard, be assured that you’ll have a job at CVS Health when you return from deployment. And, even though your civilian job may differ from your military job, we have many opportunities that may be right for you.

We recognize the value of military spouses bring to our company and continue to look for ways to help you find employment.

Explore our career areas and learn more about continuing your mission to help others.

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