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Member Billing Specialist

Humana

Humana

This job is no longer accepting applications

See open jobs at Humana.
Wisconsin, USA · Remote
Posted on Tuesday, February 13, 2024

Become a part of our caring community and help us put health first

As a Member Billing Specialist, you will collaborate with members, guardians, providers and internal staff to ensure accurate and timely financial information reporting. You will provide a full range of revenue/accounts receivable, accounting, and reporting functions to meet federal and state requirements.

  • Calculate Room & Board liability for members in residential placements using income information from Cares Worker Web and determine allowance to be used to offset Cost Share and Room & Board.
  • Prepare and send out monthly billing statement to all members with Patient Liability, Room & Board and/or Cost Share obligations.
  • Track nursing home placements to ensure timely budget changes through Income Maintenance which will ensure accurate and timely billing of Patient Liability.
  • Notify Income Maintenance (IM) upon discovery of changes in member financial information, Monitors Cares Worker Web to ensure that IM has processed the update, and update member billing as appropriate.
  • Reconcile Forward Health Cost Share Report to Cost Share/Patient Liability currently billed in MATRIX system.
  • Review member accounts monthly for credit balances and determine if a refund will need to be issued. Prepare refund request as needed.
  • Lead collection of members outstanding balances due.
  • Provide exceptional customer service to address member and internal stakeholder questions and concerns and send professional correspondences as the need is identified.
  • Make recommendations for efficiencies and maintain policies and procedures related to billing, and complete other miscellaneous billing department functions


Use your skills to make an impact

Required Qualifications

  • 1 year of Customer Service experience in billing and/or collections
  • Strong communication skills
  • Excellent organizational skills
  • Excellent computer skills including basic Excel
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  • Residing in or nearby the State of Wisconsin

Preferred Qualifications

  • Associate's degree in Accounting or Business
  • 2 or more years of experience in billing and collections
  • Healthcare experience

Additional Information

Scheduled Weekly Hours

40


About us

About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

This job is no longer accepting applications

See open jobs at Humana.