Premium Billing and Enrollment Business Lead
Freelancers Union is sponsoring new, member-driven, nonprofit health plans in Oregon, New Jersey, and New York. Independent Worker Services (a subsidiary of Freelancers Union) is looking for passionate, entrepreneurial employees to support these Consumer Operated and Oriented Plans (CO-OPs) and be part of the latest innovation in health care—one that will provide more affordable insurance benefits to thousands of Americans.
We’re collaborative, friendly, open-minded, adaptable, creative, and action-oriented, and we’re looking for people who share those qualities. We work in a fast-paced and fun environment, and we’re constantly exploring interesting new ideas.
We are seeking a talented Billing and Enrollment Specialist to coordinate health insurance billing and enrollment activities for three CO-OPs. This position requires a thorough understanding of health insurance eligibility and enrollment processes, as well and individual and group billing operations.
What you’d have to do:
- Provide subject matter expertise and business analysis for functional, project and technical teams to support the implementation of a billing and enrollment third-party administrator (TPA), including eligibility, enrollment, billing and payment services, and how those functions affect claims payment, customer service, and other processes
- Collaborate with the Project Management Office (PMO) to develop and validate requirements and process flows for end-to-end business processes and system functionality
- Evaluate proposed vendor policies and procedures and promote best practices and improvements based on business needs
- Review and make recommendations for contractual Service Level Agreements (SLAs) and reporting needs
- Prepare comprehensive use cases for systems QA
- Document issues and aid Senior Management decision-making by facilitating discussions
Experience and skills you’d need to have:
- At least 3 years of experience in health plan administration, particularly in an enrollment, premium billing and payment collection capacity; experience in business lead or analyst role will also be highly valued
- Comprehensive knowledge of eligibility and enrollment systems and data, including a working knowledge data transfers, specifically EDI file transfers
- Comprehensive knowledge of individual and group billing practices
- Excellent interpersonal and written/verbal communication skills
- Ability to work and communicate in a cross-functional team environment
- Ability to work in a creative team environment
- Proficiency of the MS Office Suite with some knowledge of databases, and a through working knowledge of customer and vendor facing premium billing and enrollment systems.
- Bachelor's degree from a four-year accredited college or university
If you’re interested in joining our team of entrepreneurial pioneers, please email your resume and cover letter with salary requirements to: resume @freelancersunion.org. Sorry, but we won’t consider resumes that don’t include both a cover letter and salary requirements.
We look forward to hearing from you!
Working Today/Freelancers Union and its entities do not discriminate on the basis of race, sex, color, religion, national origin, age, disability or veteran status in its programs, activities or employment practices.