Billing Specialist

Delta Dental of California
$36,900 - $74,600
paid time off, paid holidays, tuition reimbursement, 401(k), employee discount
United States, Georgia, Alpharetta
Dec 24, 2024
JOB DESCRIPTION This position uses a broad knowledge of multiple business areas (Enrollment, Accounts Receivable, Configuration, Onboarding) to track and perform premium reconciliations for payment received against invoice amount billed. This position is also responsible for analyzing premium back-up, resolving outstanding balances, and overall account resolution while delivering superior, consultative customer service for a wide variety of clients. This position takes the lead to audit, determine root cause for issues and deviations requiring manual intervention, recommends and executes action items to resolve them directly with the client. RESPONSIBILITIES Ensures accurate billing for all cycles (weekly, biweekly, monthly billing, etc.) including creation and processing Statement of Accounts (SOA) and Stabilization of Claims utilization; Performs comparison analysis before invoices release to client and resolves identified discrepancies. Provides guidance to internal and external customers on various items related to billing and reconciliation, including configuration, retroactive policy, aging balances, and impacts. When errors occur, provides feedback and recommendations to management for resolution. Reviews transaction discrepancies (TRX Compare/Revenue Analysis) and prepares ACH Debit reports; Performs quality assurance of reports and analyzes and resolves exceptions as needed. Analyzes and creates custom reporting and claims validation for accounts; Works with AR team to determine journal entry accruals. Performs discovery audits for each group assigned as a baseline including gathering payment, billing, discrepancy, and adjustment information and determining based on this history and pattern any root cause issues that cause the account to require manual intervention. Develop and execute action plans taking the lead to move customers to standard processing without manual intervention. Recommend, document and gain approvals for non-standard processes to be included in contracts. Performs all manner of reconciliations, reclass and refunds in Oracle and ad-hoc (manual) as needed; Reviews detailed payment backup analysis for discrepancies using Bump & Compare/Vlookup. Analyzes group remittance and provides guidance to AR for accurate payment application; Prepares documentation for internal and external stakeholders as needed and reviews dunning letters for propriety before sending to client. Prepares Escalations, documenting timelines, actions taken and summarization of issue for Senior leadership to review. QUALIFICATIONS 3+ years of experience w/High School. 2+ years of related experience in a billing and reconciliation role preferred. Strong organizational/time management skills and multi-tasking abilities. Detail-oriented with strong analytical and problem-solving skills. Effectively able to adapt to change and be comfortable handling risk and uncertainty. Ability to prioritize and manage duties in order to meet goals and deadlines. Strong customer service skills; customer-focused with ability to empathize with customer. PC literacy required; MSOffice skills (Outlook, Word, Excel, PowerPoint). Base Pay Information The national base pay range at the end is a good-faith estimate of what Delta Dental may pay for new hires. Actual pay may vary based on Delta Dental's assessment of the candidate's knowledge, skills, abilities (KSAs), related experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity. Pay Grade 14. $36,900 - $74,600 ADDITIONAL INFORMATION Behind the smile! We are dedicated to safeguarding the health and financial stability of our employees and their loved ones. This commitment extends beyond the workplace to foster personal growth and holistic wellbeing. Our life-changing rewards package includes: Competitive base and incentive pay 401(k) with robust matching and non-matching contributions Rich medical & pharmacy benefits 100% employer-paid dental and vision benefits Holistic wellbeing program with deep financial incentives Generous paid time off plus 12 paid holidays and your birthday off Culture of growth and learning: career development; tuition reimbursement; recognition program Family support: adoption assistance, fertility treatment, child, elder & pet care assistance Social responsibility and volunteer opportunities Employee discount program Fair Chance Ordinances and Criminal Background Considerations Qualified applicants with arrest or conviction records will be considered for employment in accordance with all applicable federal, state, and local laws, including, but not limited to, fair chance and anti-discrimination ordinances. At Delta Dental, we maintain a strict stance on theft, fraud, and violent crimes. For positions involving driving, we enforce heightened standards regarding driving records. Each individual criminal background check is evaluated on its merits, taking into account the time elapsed since the conviction, evidence of personal development and rehabilitation, and any potential risk posed to our business operations, employees, customers, or vendors. #LI-Hybrid ABOUT THE TEAM Delta Dental is an equal opportunity employer. We are committed to building and maintaining a diverse and inclusive workplace for all employees. Applicants will not be discriminated against because of race, color, religion, creed, national origin, ancestry, citizenship status, sex (including pregnancy), sexual orientation, gender or identity expression, age, disability, marital status, medical status, veteran status or any other status protected under federal, state, or local law. In addition to federal law requirements, Delta Dental complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Unfortunately, our Delta Dental Enterprise is unable to hire individuals residing in Alaska, Hawaii, Maine, Nebraska, New Hampshire, North Dakota, Oklahoma, Vermont, West Virginia, Wyoming, Washington DC, Puerto Rico or other US Territories or outside of the United States at this time.