Health Plans, Inc.

Billing Manager

Health Plans, Inc.  •  $88k - $102k/yr  •  United States (Remote)  •  3 hours ago
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Job Description

Department: Financial Operations

Reports To: Vice President, Financial Reporting

FLSA Status: Exempt

About HPI

At HPI, we are a forward-thinking, national third-party administrator (TPA) specializing in self-funded health plan solutions. With over 44 years of industry expertise, our entrepreneurial spirit, flexible approach, and personalized service have empowered us to serve clients of all sizes across diverse industries. We deliver innovative strategies that maximize the value of every healthcare dollar.

The self-funded health plan landscape is constantly evolving. At HPI, our partners benefit from having a TPA with the expertise, resources, and creativity to deliver customized plan solutions that help them win and retain more business. We excel at driving costs down and managing risk, while enhancing our clients’ employees’ health insurance experience. Our goal is to help members clearly understand their health plan and provide responsive service, enabling them to fully utilize their benefits and achieve greater health.

Our commitment extends beyond our clients to our own employees. We foster a supportive and inclusive work environment where innovation thrives. By investing in our team’s growth and well-being, we ensure they are equipped to provide exceptional service.

The Billing Manager plays a pivotal role in the third party administrator, overseeing billing operations to ensure accuracy, compliance, and efficiency. This position combines leadership, technical expertise, and a strong understanding of billing processes. The Billing Manager is responsible for guiding a team, optimizing workflows, and maintaining high standards of customer service.

Duties and Responsibilities (other duties may be assigned)

  • Team Leadership
    • Supervise, mentor, and train billing team members.
    • Foster a collaborative and positive work environment.
    • Assign tasks and monitor performance to ensure targets are met.
  • Billing Operations
    • Oversee daily billing activities, including billing coordination, billing, and reconciliation.
    • Ensure timely and accurate submission of invoices to clients.
    • Review and resolve billing discrepancies or errors.
  • Compliance & Quality Assurance
    • Maintain up-to-date knowledge of industry regulations and payer requirements.
    • Ensure billing practices comply with HIPAA and other relevant standards.
    • Conduct regular audits to identify and correct issues.
  • Customer Service
    • Address escalated billing inquiries from clients.
    • Provide clear explanations of billing procedures and resolve concerns promptly.
    • Support the team in delivering excellent service.
  • Process Improvement
    • Identify opportunities to streamline billing workflows.
    • Implement best practices and new technologies to enhance efficiency.
    • Collaborate with other departments to optimize cross-functional processes.
  • Reporting & Analysis
    • Generate and analyze billing reports to track performance metrics.
    • Present findings and recommendations to management.
    • Monitor key indicators such as billing accuracy and invoice punctuality.
  • Integration Lead
    • Prior experience in leading the Billing department in software migrations
    • Ability to successfully lead the migration of the Medcost clients from the PowerStepp system to the Javelina system.
  • Other duties as assigned by the Finance Department management team.

Minimum Education Requirements

  • Associate’s or Bachelor’s degree in Healthcare Administration, Finance, or Business related discipline preferred.

Minimum Experience Requirements

  • 5-7 years of experience in Finance department at a third-party administrator of health plans in billing
  • Strong organizational skills with the ability to manage multiple priorities
  • Exceptional attention to detail and accuracy
  • Proven ability to meet deadlines in a fast-paced environment
  • Effective verbal and written communication skills; experienced in collaborating with internal teams, vendors, and customers to resolve inquiries
  • Skilled at working cross-functionally to identify and resolve business process challenges
  • Excellent knowledge of MS office and familiarity with relevant computer software (e.g. SAP)

Preferred Experience Requirements

  • ACA, ACCA or CIMA is a plus

Computer Skills:

  • Proficient in Microsoft Office, including Word, Excel, Outlook and PowerPoint.

Reasonable Accommodation:

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the duties and responsibilities of the position.

Working Environment/Physical Demands:

The work environment characteristics and physical demands described here are representative of those an employee may encounter while performing the duties of this job.

The noise level in the work environment is moderate. The employee may occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus. While performing the duties of this job, the employee is regularly required to sit, walk, speak, or hear. The employee is frequently required to use hands or feel or handle items as well as reach with hands and arms. The employee is occasionally required to stand.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position.

Health Plans Inc. is an EEO – M/F/D/V employer

Health Plans, Inc.

About Health Plans, Inc.

HPI redefines what is possible with self-funded health plans. As a third-party administrator, we partner with health plan brokers and employers to provide innovative self-funding strategies and customized plans tailored to each client’s needs and population. Our solutions give employers greater cost transparency and control, while elevating the member experience.

Industry
Finance & Insurance
Company Size
201-500 employees
Headquarters
Westborough, MA
Year Founded
1981
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