Hybrid Billing Administrator presso Hawaii Dental Service

POSITION SUMMARY

Under the direction of the Billing Manager, performs duties related to the Billing department (IDP, Employer Groups, and COBRA), including preparing month-end reconciliations, preparing monthly comprehensive reports, collecting, reconciling, and auditing payments, and providing administration services in accordance with current rules and regulations.  Responsible for planning, supporting, and implementing various projects and technology tools, and provides training, troubleshooting, and support for the department and to groups and members.  Assists the Billing Manager in reviewing random samples of recorded calls and providing coaching/feedback, ensuring work processes are compliant with regulations, guidelines, and customer contracts.   Evaluates the effectiveness of processes, identifies system or workflow issues, and recommends solutions.   Analyzes, researches, and resolves customer issues.  Assists Billing Manager in assuring company and departmental goals and objectives are met and work processes are in compliance with departmental practices and policies.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Billing Administration Services
  1. Validates the accuracy of self-insured bills by verifying claims and administrative expense fees in accordance with SOC1 controls.  Maintains a comprehensive understanding of the billing of diverse program types and requirements, complex funding arrangements, and the interrelationship of the eligibility, contract, and billing/accounting system applications.   Reviews, researches, and analyzes billing discrepancies to determine corrective action.  
  2. Coordinates electronic payment activities for groups.  Updates systems for manual bank account changes, verifies payments, follows up on failed transactions, collects premiums, and processes credit card refunds.
  3. Provides internal and external customer assistance utilizing a comprehensive understanding of HDS policies and practices related to billing, COBRA, Individual Dental Plans (IDP), eligibility, and contracts.  Actively listens to customers, interprets needs, and determines course of action.  Conducts research to quickly and effectively resolve customer issues.  
  4. Processes credit card transactions by phone.
     • Resolves credit card processing issues.
     • Prepares credit card refund requests and notifications related to credit card expirations.
  5. Reconciles month-end transactions for individual and group credit card payments.
  6. Promotes and assists group administrators with HDS Online services, including online billing and automatic payments. Educates on system advantages and supports users on system capabilities. 
• Accounting & Reporting
  1. Collects delinquent premiums, monitors payments and documents collection efforts, and discussions regarding payment status. Advises groups of potential consequences of further non-payment and notifies management of accounts at risk.  Reports the monthly termination list for Management approval.   Reconciles payments, conducts research, and works with groups, IDP members, or internal departments to determine actions needed to resolve payment, billing, eligibility, or collection issues.   Identifies and resolves cash posting discrepancies and proposes recommendations to improve accuracy. Completes the reconciliation of premium files to HDS invoice extracts and resolves any discrepancies. 
  2. Processes prenote files and the monthly ACH deductions, generating ACH files to the bank for processing while researching discrepancies in payments and other payment-related matters.  Prepares appropriate manual refund requests.
  3. Completes month-end accounts receivable reconciliations and determines whether adjustments are warranted in the system to reflect a group's proper balance.   Prepares reports for Minimum Funding and Self-Insured groups utilizing information obtained from multiple sources, informing groups of their financial status of their contracts each month.  
  4. Audits and verifies group cash receipts to ensure that payments are accurately posted and follows up with groups if there are discrepancies in payment amounts.
  5. Prepares IDP statistical information for analysis.
• Technology & Testing
  1. COBRA
     • Maintains accuracy of current COBRA rates in the Travis COBRA Administration System and analyzes processes related to enrollments, payments, and notifications to improve overall COBRA administration for groups.  Sets up new group benefits and rates in Travis. Processes and transmits BESS files and audits eligibility changes to ensure synchronization of the Travis COBRA System and LED eligibility. 
     • Acts as a liaison with Travis Software Inc. in the event of COBRA system issues.
  2. IDP - Works closely with the other departments during the IDP annual renewal process to understand any process changes, new system enhancements, and communications to IDP and HCG members while ensuring that financial transactions are being handled appropriately.
  3. Assists in the development, design, and testing of system enhancements.
  4. Monitors processes after system deployments and provides feedback on effectiveness.   Maintains the Billing Tab in Group Data to ensure updates are accurately and timely completed and that the overall existing information is accurately reflected.
  5. Evaluates the effectiveness of the billing process and proposes recommendations for enhancements. Assists with COBRA Monitoring. Provide training, as necessary, to HDS staff, brokers, employer groups, subscribers, and members.  
• Training and Policies & Procedures
  1. Assists in training new staff in the daily operations of the Billing department, as well as identifies training needs on new processes or procedures.
  2. Assists with the design, writing, maintenance, and production of departmental manuals, including but not limited to standards of operation, training, and user processing manuals, seeking opportunities to increase operational effectiveness and efficiency of the department.
• Other Duties and Responsibilities

• Serves as the backup in the daily operations of the Billing Department in the absence of the Billing Manager or other billing personnel.
• Assists the Billing Manager, Controller, or Chief Financial Officer with special projects.
• Other miscellaneous duties and responsibilities as assigned.

MINIMUM QUALIFICATIONS AND EXPERIENCE

Education

Bachelor's Degree in Business Administration with an emphasis in Accounting preferred or an equivalent combination of education, training, or working experience which would provide the necessary knowledge, skills, and abilities to meet the minimum qualifications to perform the essential functions of this position. 

Experience

Skills and Knowledge

• Mindset of continuous improvement and finding new and better ways of performing the job, seeking solutions, and exercising good judgement.  
• Self-motivated, pursues job knowledge and development.
• Strong analytical skills, including the ability to define problems, collect and organize data, analyze and understand various sources of information, and problem-solve complex issues.
• Ability to evaluate overall effectiveness and impact of process changes.
• Ability to learn, thoroughly comprehend, and communicate COBRA regulations and related HDS policies. 
• Requires organization and ability to manage multiple tasks and maintain focus with attention to detail.
• Ability to work under minimal supervision.
• Ability to handle all information in a confidential manner and in compliance with federal and state laws/regulations (i.e., HIPAA, PHI).
• Working knowledge of PC applications (Windows, Word, and Excel) highly desirable for problem-solving, including the ability to understand the interrelationship of multiple system applications.

Note: The above information on this description has been designed to indicate the general nature and level of work performed by an employee in this classification.  It is not to be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications of employees assigned to this job.  Hawaii Dental Service has the right to add to, revise, or delete information in this description.  Reasonable accommodations will be made to enable qualified individuals with disabilities to perform the essential functions of this position.