Job Description
Billing Consultant is responsible to ensure dues are finalized and money is collected and allocated across benefits and structure. Work to improve financial results by reducing losses associated with non-payment. Deliver consultative and professional services to our clients by preparing and delivering an accurate invoice, collecting and posting payments timely, reconciling payments, reporting and resolving discrepancies. Responsible for providing timely responses on financial reports on a monthly basis.
Fundamental Components
• Reviews Plan Sponsor member listings, Plan Sponsor (or individual member) payments, and/or terminations and compares to actual billing statement to identify and resolve discrepancies.
• Monitors, researches, and resolves collection of outstanding premium or revenue adjustment issues and reports corrections to appropriate contact; Resolution activity related to delinquent accounts may involve verbal and/or written communications with customers and other key internal business areas.
• Ensures all manual adjustments, refunds, and write-offs are appropriately submitted, adhering to policy guidelines. Validates and updates Self Insured Revenue forecasting information and trends.
• Coordinates validation of eligibility on fully insured and/or self-insured customers.
• Applies technical policy, legislation, Plan Sponsor account structure and benefit information to decisions.
• Codes rates and structure on new cases and renewals/revisions, in system to provide customer with accurate and timely invoices and to send data to downstream systems.
• Ensures that remittances are posted accurately across various benefits and account structure and reconciles customer remittances; Related activities may include negotiating payment schedules and settlements.
• Identifies and determines appropriate treatment of overdue accounts and coordinates collection and cancellation of overdue customers in accordance with pre-established market segment process.
• Consults with internal/external customers to identify accurate account structure, billing format method and payment arrangements to meet customer expectations.
• Provides assistance and/or mentor internal and external constituents.
• Reviews Non-Admit reports to ensure that Plan Sponsor's balances are within statutory guidelines.
• Identifies electronic media prospects as it relates to premium payment back up and routinely contact and follow up with potential electronic candidates and finalizes electronic workflows with Plan Sponsor and/or vendor.
• Communicates and negotiates with Fortune 500 customers for prompt and accurate payment of amounts due.
• Researches, resolves and responds to billing inquiries/member issues generated from Plan Sponsor, third party vendor, Member Services or marketing office. Answers questions and resolves issues based on phone calls/letters from Plan Sponsors and internal constituents.
Background Experience
• Financial/Accounting experience a plus.
• Must be able to work independently as well as in a team environment.
• Able to multi-task and problem solve.
• Good listener with the ability and confidence to interact effectively with both internal and external contacts. Attention to detail, excellent verbal and written communication as well as analytical skills preferred.
• Proficiency in Microsoft excel ex: V-loopup & Pivot tables.
Additional Job Information
Ability to analyze financial information and reports.Ability to prioritize tasks/work effectively.Strong verbal and written communication skills.Strong organization skills.Math and accounting skills.Problem solving skills.Attention to detail and accuracy.
Education
Bachelor's degree or equivalent experience
Percent of Travel Required
0 - 10%
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. Mid Level Employment Type: OTHER