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Individual Billing Specialist

Company: PacificSource
Location: Springfield
Posted on: February 10, 2020

Job Description:

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Position Title:

Individual Billing Specialist I

Date Prepared:

January 2020

Department:

Commercial Membership Services

Reports to:

Commercial Membership Services Team Leader

Status/Wage Grade:

Nonexempt, Grade 16

Job Family:

Individual Contributor

Position Number:

1447

EEO:

5-52

Position Overview: Administer Individual policyholder accounts. Provide customer service by phone and email to brokers and members. Review and post daily payments, and reconcile accounts. Process member terminations and reinstatements. Monitor reports that pertain to account balances, and delinquency status. Set up and process credit card payments and electronic fund transfers. Monitor past due payments and generate letters.

Essential Responsibilities:

Provide customer service to external customers via the Individual phone queue, e-mail, and walk-in visits from customers. Process lockbox and manual deposits daily. Prepare setup, staging, and spreadsheet with receipt totals to Finance. Process credit card payments as required. Update member information based on documentation received. Complete reinstatement requests for members termed for non-payment of premiums when eligible. Complete cash transfer forms between accounts when required on an as-needed basis. Generate various letters as needed, according to state laws. Monitor report of Individual members with past due balances. Generate letters requesting payment due to insufficient funds, or credit card expiration and declinations. Set up and maintain Electronic Fund Transfer (EFT) records in system. Audit file of electronic funds transfer transactions for Individual members. Assure all activations, terminations, and change requests meet compliance standards as defined by Finance. Generate letters and monitor account balances of EFT members. Audit the Termed Members with Balance report and complete write off forms and log refund requests. Complete suspend delinquency form when payment is received in regional offices on last day of month to prevent auto-termination utilizing the Universal Check Log. Process member terminations upon written request. Work with the Individual Service Team to ensure hand-offs between the teams are efficient and timely. Research and resolve issues that report on the Billing Entities in an Error Status and Individual Bills Not Produced reports. Report issues and resolution to the department Team Leader.

Supporting Responsibilities:

Participate in Visual Board daily review, team and department meetings, mentor training, and team building activities as directed. Participate in various committees and meetings as scheduled. Provide support to the Commercial Enrollment & Billing Department as needed. Meet or exceed accuracy standards and PRISM measures as required. Meet department and company performance and attendance expectations. Assist with policy and procedure updates as requested. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: Minimum of one year prior Accounting /Accounts Receivable experience with strong keyboarding and 10-key experience required. Accounts Receivable experience and Excel skills strongly preferred.

Education, Certificates, Licenses: High school diploma or equivalent required.

Knowledge: Ability to understand and interpret Federal, and State laws and PacificSource contract provisions. Excellent verbal, telephone and written communication skills. Strong customer service skills required. Ability to adhere to company and department policies and meet expectations for service, accuracy and efficiency.

Competencies

Our Values

  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards

    • We are committed to doing the right thing.
    • We are one team working toward a common goal.
    • We are each responsible for our customers' experience.
    • We practice open communication at all levels of the company to foster individual, team and company growth.
    • We actively participate in efforts to improve our communities-internal and external.
    • We encourage creativity, innovation, and the pursuit of excellence.

      Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.

      Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

      Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

      Approval:

      Manager Date Employee Date

      Our Values
      • We are committed to doing the right thing.
      • We are one team working toward a common goal.
      • We are each responsible for customer service.
      • We practice open communication at all levels of the company to foster individual, team and company growth.
      • We actively participate in efforts to improve our many communities-internally and externally.
      • We encourage creativity, innovation, and the pursuit of excellence.

        Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

        Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Keywords: PacificSource, Springfield , Individual Billing Specialist, Accounting, Auditing , Springfield, Oregon

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