Billing Specialist Associate
Core
Investigate and resolve complex payment and billing cases, including reimbursement discrepancies, cost-share issues, and claims adjudication questions to ensure smooth member reimbursement processing.
Role type
Associate billing specialist (payment operations)
Builds
Backend system corrective actions and recovery plans for payment discrepancies
Domain
Healthcare administration and medical billing
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Medical billing, reimbursement processing, insurance claims processing, revenue cycle management, payments lifecycle, benefits design, claim adjudication, ticketing tools, reporting tools, root-cause analysis, cross-functional collaboration
Preferred skills
Creative problem-solving, resourcefulness, adapting to shifting priorities
Technologies
Jira, Zendesk, Google Sheets, Looker
Responsibilities
Investigate and resolve escalated cases regarding reimbursement processing discrepancies, accumulator/cost-share issues, eligibility questions, and claims lifecycle/adjudication; Execute backend system corrective actions for billing and cost-share determinations; Coordinate with internal teams including Member Benefits Services, Adjudication, Payment Operations, Product, Client Success, and Client Operations; Maintain complete, audit-ready documentation on every case.
Seniority
Mid-level, hands-on IC
