Provides direct back up support for Premium Billing and Dunning processes.Assists with questions and complex issues relating to employer group payments.
Duties and Responsibilities:
•Reviews Billing files for errors causing premium billing to fail. Also reviews the monthly Billing extract files for accuracy.Intervenes with Enrollment or Sales departments for problem resolution and root cause.
•Reconciles employer group premium statements regarding discrepancies when there is an outstanding receivable balance. Identifies and documents all components of the receivable balance with minimal errors.Works to recover or resolve outstanding debits and credits to share with the Employer Group.
•Enters and monitors billing discrepancies for both active and terminated groups. Documents the status or retrieval of dollars relating to same.
•Adjusts customer accounts by entering discretionary billing items, requesting rebills and updating billing entity records.
•Performs monthly analysis of the Billing Aging reports to identify miscellaneous open invoices or balances. Determines the disposition and takes the necessary action to resolve the aging or relieve the receivables.
•Reviews the Dunning Reports and Notices for all lines of business. Compiles and generates spreadsheets capturing key data for the dunning process. Creates pivot tables, modifies spreadsheets and formats the data within to achieve the analytical goals of the Billing/Configuration Team.
•Upon request, completes regulatory forms for employer groups.
•Researches accounts, provides decisions and rationale on individual customer complaints regarding premium billing and dunning.
•Provides thorough research of individual accounts involving multiple systems to ensure member is enrolled correctly and billing is accurate.
•Handles various reconciliation processes. Compares enrollment to billing data. Processes rescinds and credits.
•Completes yearly reconciliation audits when requested by an employer group.
•Reviews the Address Report and works other teams to resolve address discrepancies.
•Prepares refund requests when a customer has a credit balance appearing on their account. Creates payment histories upon request or whenever necessary to justify account balances for individual members and employer groups.
Competencies and Skills:
Demonstrates organizational skills and the ability to independently problem solve and follow through on issues to resolution.
Demonstrates exemplary Customer Service by communicating and resolving issues with internal and external customers in a professional and timely manner.
Must be extremely detail-oriented.
Projects image of GHP's dedication to professional excellence.
Demonstrates proficiency in computer operations including software applications in desktop publications, as well as presentation, spreadsheet and network applications.
Demonstrates the ability to work in a multi-task environment where there are pressures of production schedules and deadlines.
Demonstrate skill in mathematics/statistical analysis.
Demonstrates strong writing and verbal presentation skills.
Demonstrates the ability to influence others and work collaboratively in order to produce results across multiple functional teams
Education / Experience:
High School Diploma or Equivalent -Required
Minimum of 4 years Relevant experience* -Required
*Relevant experience may be a combination of related work experience and degree obtained (Associate’s Degree = 2 years; Bachelor’s Degree = 4 years
Working Conditions/Physical Demands:
Work is typically performed in an office environment. Travel may be required.
Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
Geisinger Health Plan (GHP) is the health insurance component of Geisinger and serves over 460,000 members in Pennsylvania. Begun in 1985, GHP provides high quality, affordable health-care benefits for businesses of all sizes, individuals and families, and Medicare beneficiaries.
About Geisinger: Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
Internal Number: 65760
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.