General Summary: To maintain the integrity of enrollment data as it relates to membership, premium dollars, and collection of revenues. This function includes validating premium dollars paid against the invoice(s) billed for all employer group business at HAP. All disputes or discrepancies will be analyzed and resolved prior to the next billing period. Obtain final resolution of account discrepancies by effectively communicating all findings internally and externally to agents, groups, sales and various levels of departmental personnel in writing, direct contact, or by telephone. Document all findings into HAP's multiple internal and external systems and advise department leadership when necessary to ensure accurate and timely issue resolution. Principal Duties and Responsibilities:
Accurate preparation and oversight of employer group premium billing. Validate total contracts billed plus all prior month balances and adjustments.
Balance group billings with premium received for corresponding numbers and types of contracts covered. Validate the accuracy of additions, deletions and service changes.
Communicate, interpret and implement corporate account policies and procedures according to the group contract by upholding retro limitations according to the group contract.
Establish and maintain effective communication with all assigned group accounts. Assist the group accounts in facilitating accurate reporting data.
Handle incoming and outgoing telephone inquiries from internal departments as well as employer group and agents representing employer group.
Perform monthly group audits in accordance with established principles and practices. Identify account discrepancies as a result of positive audit reconciliation. Communicate with employer group account discrepancies and remittance of premium dollars, and documenting conversations using system software.
Apply unapplied premium dollars to the appropriate invoices and allocate credit memos to appropriate invoices by month end deadlines.
Meet established deadlines for batch completion and department standards as it relates to the quality and quantity of work performed.
Work with Accounts Receivables to facilitate the monthly group dunning and allowance for bad debt by identifying the collectability of balances due.
Ensure that membership transactions are processed timely from discrepancies identified by the reconciliation of group premiums. Confirm that all work is completed prior to next month’s billing cycle.
Notify and assist the Marketing Reps. with group open enrollment, payment issues, and onsite group visits when necessary for resolution of past due balances.
On-site employer group visits (as needed) to resolve account discrepancy and collection of premiums owed.
Perform other related duties as assigned.
Education/Experience Required:
Highschool diploma or equivalent required. Associates Degree in Accounting/Finance/Business preferred.
Three (3) years' experience of financial analysis using a window based online production system.
Use of Microsoft Windows to include Excel, Word & Access - Advanced proficiency. Must be able to create formulas.
Minimum of (3-5) years of customer service experience in a Billing Department focusing on reconciling discrepancy issues and communicating with HAP employer groups and agents.
Minimum of three (3) years experience using Oracle Financials including application of payments, processing credit/debit memos and refunds.
Minimum of three (3) years' experience in Cognos.
Minimum of three (3) years' experience in Membership department processing eligibility transactions.
Skills and Abilities:
Must possess strong analytical and problem-solving skills.
Ability to type 30 wpm.
Must be able to utilize and comprehend the concepts of a windows data base environment.
Must be able to create formulas and function in MS Excel.
Must be able to maintain the confidentiality of the work and all business contacts.
Ability to work effectively and independently with minimal supervision.
Ability to communicate effectively with internal and external customers.
Ability to interpret corporate policies and procedures regarding eligibility requirements, group operating agreements, etc.
Ability to prioritize work to meet month end deadlines and standards for quality over quantity with emphasis on reconciliation.
Additional Information
Organization: HAP (Health Alliance Plan)
Department: Enrollment & Billing Admin
Shift: Day Job
Union Code: Office/Non-Exempt, HAP
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
OverviewPartnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan’s largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more athenryford.com.BenefitsWhether it's offering a new medical option, helping you make healthier lifestyle choices or
making the employee enrollment selection experience easier, it's all about choice. Henry
Ford Health has a new approach for its employee benefits program - My Choice
Rewards. My Choice Rewards is a program as diverse as the people it serves. There are
dozens of options for all of our employees including compensation, benefits, work/life balance
and learning - options that enhance your career and add value to your personal life. As an
employee you are provided access to Retirement Programs, an Employee Assistance Program
(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.Equal Employment Opportunity/Affirmative Action EmployerEqual Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.
