JOB SUMMARY
This job is responsible for the claims invoicing and accounts receivable activities for the non-risk self-insured population of clients supporting all medical, buy-up, shared savings, drug, branded and non-branded dental, and spending account products. This job will create and maintain customer accounts by auditing all changes in the system that will impact the billing and/or accounts receivable activity for the self-funded customer base; review and analyze weekly management/trending reports; run basic (SQL) queries based on customer specific needs; reconcile and analyze payment activity for self-billed administrative clients to ensure compliance with audit thresholds; must be able to interact well with a cross-functional set of internal stakeholders (Sales, Information Technology, Management, Finance/Accounting, Underwriting) as well as external stakeholders; must be able to work in a fast-paced environment with daily work processing deadlines; and follow all HIPAA and HITECH guidelines pertaining to Protected Health Information (PHI).
EDUCATION
EDUCATION
Required
Substitutions
Preferred
EXPERIENCE
Required
Preferred
SKILLS
Language Requirement:
None
Travel Requirement:
0% - 25%
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$20.72Pay Range Maximum:
$30.12Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice

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