Billing Reconciliation Specialist

Job Title : Temporary Premium Billing Reconciliation Specialist I

Location : Portland, Maine Metropolitan Area

Position Type : Full-Time

Hours : 40 hours / week

We are seeking a Temporary Premium Billing Reconciliation Specialist I for a temporary position for our client, a healthcare organization located in Portland, ME . The Premium Billing Reconciliation Specialist will support the accuracy and integrity of enrollment data by overseeing the day-to-day operational activities of member profile management and health plan data reconciliation. This role is designed to support data entry of financial information and reconciliation of member data. The ideal candidate will be familiar with payment information (Credit Cards, ACH / EFT, etc.), payment portals, and / or QNXT systems. Strong communication and computer skills are essential.

As a Premium Billing Reconciliation Specialist I , you will be responsible for :

• Maintaining expertise in premium billing knowledge and serving as a learning resource within the team and other departments.
• Collaborating with the Finance team to ensure timely responses to member premium-related requests, inquiries, and issues.
• Meeting or exceeding department accuracy and productivity goals.
• Identifying process and workflow gaps, managing process improvement activities.
• Performing quality assurance reviews on reporting and data to identify trending issues and opportunities for resolution.
• Assisting with compliance and audit activities, including compiling documentation requested by internal and external auditors and implementing corrective action plans as needed.
• Managing account investigations and quality assurance of data found in the premium billing system.
• Processing member premium refunds and corrections as needed.
• Resolving escalated premium-related inquiries from members, external customers, and key stakeholders.
• Responsible for daily payment posting, upload, or electronic payment processes and applications.
• Identifying system and process defects and providing recommendations for solutions.
• Working closely with the Premium Billing Specialist II to manage the status and accuracy of overdue or underpaid accounts.

The ideal candidate for this role will have :

Featured benefits