Premium Billing Analyst II

Presbyterian is seeking a Premium Billing Analyst II

Under general supervision, executes all functions and analysis with regard to billing and collection activities for Small and Large groups, Self-Billed, ASO Groups, and Medicare line of business. Performs complex account reconciliation, resolution of discrepancies, and processing of member and group terminations resulting from account reconciliation. Provides exceptional customer service with internal and external customers. Performs monthly invoice audits of new and existing groups. Functions as back up for Urgent Member Issues and Hot Phone calls

We're determined to take care of those working in healthcare.

Presbyterian is dedicated to improving people's lives - the lives of our patients and the lives of our coworkers. We're locally owned and operated, which encourages supportive leadership that emplowers employees. And we provide the opportunity to gorw from entry-level to the most senior positions.

Why Join Us

• Full Time - Exempt: No
• Job is based at Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Ideal Candidate: 3 years account billing and collections experience preferably with strong accounting and /or bookkeeping experience in health insurance industry

• HIGH SCHOOL DIPLOMA
• 3 years account billing and collections experience preferably with strong accounting and /or bookkeeping experience in health insurance industry or college degree with 2 years experience.
• Requires detailed knowledge of Health Plan portfolio (ASO, Self-billed, Medicare, Individual and Group plans) billing and follow up.
• Demonstrates competency in desktop software applications including Word, Excel, and Microsoft Access.

• Responsible for complex group insurance customer billing and accounts receivable.
• Provides service to customers regarding types of payments, reconciles complex accounts, and handles collections and reinstatements.
• Process monthly Self billed and ASO account reconciliations including resolution of discrepancies
• Perform billing and collections for Government Programs
•  Performs Self billed reconciliation for the life of the group and analyzes and reports financial information to customers.
• Analyzes billing errors and billing queries in order to correct errors.
• May provide guidance or expertise to less experienced representatives.
• Other duties as assigned.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to ensure the patients, members and communities we serve can achieve their best health. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

USD $24.71/Hr.

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.