Billing Analyst Level I

Under the direction of Billing and Vendor Management Leadership, uses relevant computer software applications to provide interpretation of the premium summary, member activity, retroactive rate changes, and additional items on each invoice sent to members. Provides technical expertise regarding the relevant computer software applications to other departments as necessary. Analyzes billed amounts not paid and determines the reason; conducts outreach to BCBSWY members about billing related issues.

• Resolves discrepancies within billing and accounts receivable items related to premium billing.

• Performs service recovery actions with BCBSWY members and internal staff for instances where payments are short, overpaid, or where billing changes require verbal clarification.
  • Monitors aging of accounts receivable by working applicable reports weekly.
• Reviews discrepancies between the member and our system and be able to explain the discrepancies in a clear and concise manner.
• Determines timeliness of payments received and if applied correctly.
• Monitors and researches unallocated funds and determines how to handle these funds in a timely manner.
• Provides professional and accurate guidance to members about how to view payment history and billed amounts, so as to reduce audit requests.
• Assists with management of relationships with vendors.

• Performs quality control activities for all assigned items received and worked in the department.
• Monitors timeliness of bills.
• Conducts all job functions with adherence to Blue Cross and Blue Shield Association standards for timeliness.
• Answers questions from department staff regarding billing items and escalates issues to management when appropriate.
• Works towards quality initiatives.

• Other duties as assigned.

• Ability to develop and maintain a working knowledge of the health insurance industry, products marketed by BCBSWY, and the billing impact relating to these practices and products.
• Excellent telephone presence with proven customer service skills.
• Strong organizational skills with the ability to balance the demands of multiple tasks.
• Ability to prioritize with high attention to detail.
• Working knowledge of Microsoft Excel, Word and Access.
• Good communication skills and analytic capabilities a must, especially relating to invoices and the use of debits and credits.

• Ability to develop and maintain a comprehensive knowledge of BCBSWY accounts receivable system and applicable reporting.
• Ability to develop and maintain a working knowledge of dedicated computer platforms and vendor portal functionality.

• Associates degree (typically in accounting, business, management, finance, or marketing) or equivalent applicable work experience required.

• Six months of applicable work experience (typically in accounting, billing, medical office/health care) needed; 1+ year(s) experience with account reconciliation recommended.