Role Description Performs moderately advanced benefits program administration and member assistance work. Work involves determining benefits eligibility, processing applications for benefits, and providing guidance to Benefit Coordinators with benefits eligibility inquiries. Works under moderate supervision, with some latitude for the use of initiative and independent judgment. The ideal candidate for this position will have a comprehensive understanding of employee benefits, strong problem-solving skills, excellent verbal and written communication skills, a commitment to customer service, enjoy interacting with people, and be comfortable working in a fast-paced and structured environment. Qualifications - Strong knowledge of eligibility requirements including Section 125 and COBRA rules. - Strong knowledge of MS Office and billing and enrollment software. - Strong problem-solving and research skills. - Ability to effectively communicate complex benefits administration subjects both verbally and in writing. - Effective time management, organization, and prioritization skills. - Advanced knowledge of TXHB products, benefit terminology, benefits design, and eligibility rules. - Ability to work in a team environment and perform multi-task job functions. - Strong service-oriented communication skills, including the ability to empathize with others and diffuse tense situations when needed. - Ability to convey a professional manner in dealing with others and maintain constructive working relationships. - Self-motivated to fulfill tasks, resolve issues promptly, and meet deadlines. - Ability to effectively work within rapidly changing circumstances as needed. Requirements - 1-2 years of work experience in a related field such as Human Resources or health insurance. - Graduation from an accredited four-year college or university with major coursework in business administration, insurance, or a related field is preferred. - Experience working in a service-oriented position, where customer satisfaction is a key performance indicator is preferred. Benefits - 100% Remote (MON-FRI) - Work Schedule: 8:00 AM - 5:00 PM (MON-FRI) Essential Duties and Responsibilities - Answers incoming inquiries (e.g. phone calls, emails, etc.) from Benefit and Billing Coordinators regarding benefit administration, eligibility, billing, and any other questions regarding employee benefits. - Contacts benefit coordinators to resolve potential issues that have been identified internally. - Clearly documents case activities, outcomes, and feedback received by members. - Proactively handles own caseload and shared work queues to ensure timely resolution of escalated issues while meeting service levels and quality standards. - Processes changes to employee and dependent TXHB offered benefits, demographics, and beneficiary information. - Builds effective working relationships with Benefit Coordinators and others at assigned groups. - Serves as a resource for Benefit Coordinators, guiding and mentoring them regarding TXHB benefit administration processes, policies, and procedures. - Conducts basic data reviews of cases and inquiries to identify recurring issues, knowledge gaps, or process breakdowns and recommends potential solutions to leadership. - Proactively identifies and reaches out to Benefit Coordinators to discuss ongoing benefits or eligibility trends related to individual group benefit administration challenges. - Collaborates with other internal teams and external vendors to resolve eligibility and billing questions or issues. - Provide direction to peers by assisting with trainings as directed by Supervisor. - Participates on cross-functional project teams focused on implementing new clients, systems, or benefit programs by representing the advocate perspective and validating processes. - May review and provide feedback on AI-generated responses provided to group contacts. - May serve as a backup for cross-departmental work, including supporting special projects, documenting and testing new or updated processes, assisting with trainings, and contributing to operational readiness activities during peak periods or program changes.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role involves managing the revenue cycle by expediting and maximizing payment and resolution of insurance medical claims. - Resolve edits, denials, and payment issues in a timely manner. - Document clear, concise, and complete follow-up notes in the system for each account worked. - Ensure accounts are completed and worked at a high level of quality using HRO tools and monitoring output. - Identify, analyze, and escalate trends impacting AR collections. - Exceed established productivity goals. - Complete special projects to improve team performance as assigned. - Demonstrate expertise of all payors, including Medicare, Medicaid, and commercial payors. - Ensure protection of private health and personal information; adhere to all HIPAA compliance requirements. - Participate in educational activities and attend in-person meetings as required. - Remain current on collection and follow-up procedures of various payors and specialty departments. - Assist with knowledge sharing, payor, and department training, and provide support to other team members as advised by leadership. - Demonstrate strong technical skills and account resolution abilities. Qualifications - H.S. Diploma or Equivalent Required - Associate's Degree in Business or healthcare related field Preferred - 2 Years of PB AR management, insurance follow-up, insurance billing, or relevant revenue cycle experience Required - Preferred Experience: Epic knowledge, experience with Home Infusion, payor knowledge, claims processing, rebilling/refunds, credit balance resolution Requirements - Strong work ethic and a high level of professionalism. - High level understanding of health insurance billing, follow-up, credits, regulations, and payer requirements. - Proficient computer and EMR skills, including Microsoft Office suite applications such as Word and Excel. - Strong communication and organizational skills. - Proven experience in a billing environment. - Ability to shape communications to the needs of the audience. - Knowledgeable of HIPAA, state and federal regulations governing confidentiality, release of information, and record retention. - Familiar with Electronic Medical Record (EMR) functionality, document imaging, and workflow; Epic Care Connect EMR experience and certifications are a plus. - Dependable self-starter and deadline driven. - Ability to work well independently and in a team setting to meet organizational goals. - Solid understanding of key revenue cycle workflows, technical systems, and metric goals. Company Description

• Full understanding and ownership of the invoicing process for 1,000+ customers • Responsible for researching and solving invoicing and payment discrepancies • Responding to customer calls/emails, and making adjustments to customer accounts as needed • Responsible for the daily reconciliation and recording of incoming payments • Accountable for all aspects of the collections processes • Review contract changes to ensure billing is completed timely and accurately • Assist in the month end close and work with the team on any ad-hoc analyses

• Directly supervise Billing Managers and provide oversight, leadership, and guidance for the department • Serve as the subject matter expert and go-to person for all revenue cycle processes • Develop and implement procedures for continual quality improvement in billing to improve the accuracy and timely submission of all data to process claims according to compliance guidelines • Work with enterprise leadership to identify operations that can be modified to enhance revenue • Accountable for being knowledgeable and understanding of all aspects of the revenue cycle staff • Perform timely audits for current procedures to monitor and improve efficiency of billing and collections operations • Participate in the development and implementation of policies and procedures • Keep apprised of trends impacting charge, coding, collection, and other billing functions and take appropriate action accordingly • Participate in ongoing education efforts to keep on top of changing regulations and compliance requirements • Other duties as assigned