Manager, Claims Billing

ABOUT UNITED EDUCATORS
Over the past 12 years United Educators has committed significant resources, both staffing and financial, to creating a positive work environment where staff can do their best work every day while still maintaining a healthy work/life balance.

We have received numerous awards for best places to work including the Alliance for Workplace Excellence and Business Insurance Magazine.  We were able to show that through our management and staffing practices, we have created a diverse workforce that is highly engaged where staff work hard and have fun.  We have given our staff a voice (biennial Employee Surveys, Ask Janice, and Supervisor Evaluations) and we are committed to acting on the lessons we learn from the feedback staff give us. Our active social committee organizes a variety of events throughout the year that build our sense of community while creating some down time from the everyday stresses of work life.  Regular wellness activities and an ongoing Weight Watchers’ At Work program have helped our staff develop healthy habits that hopefully improve their life at work and at home.

POSITION PURPOSE
Has overall responsibility for the Claims Billing Coordinator staff.  Oversees high volume Claims accounts payable processes and productivity.  Responsible for high volume deductible collection (accounts receivable).  Manages the financial operations of our claims management system.  Handles payment voids and deposits.  Produces reports for senior management.  In charge of Claims Billing compliance. 
 

MINIMUM REQUIREMENTS

• Bachelor’s degree in Accounting, Business Management, Economics, or Finance and 3+ years of management experience.  Prior experience in the insurance industry or law firms preferred.  
• Strong understanding of accounts payable and accounts receivable processing in computerized accounting systems.
• Experience with LEDES formatted legal invoicing.
• Experience with processing ACH and EFT payments.
• Proficient in Microsoft Office Applications with advanced Excel skills.
• Proven ability to multi-task, work efficiently in a fast-paced environment, and collaborate with cross-functional departments.
• Strong supervisory and team building skills.
• Excellent written and oral communication skills with strong customer service and interpersonal skills.
• Must be highly organized and detail-oriented with excellent analytical and problem solving skills.
• Must have ability to thrive in an atmosphere of constant change.

MAJOR DUTIES AND RESPONSIBILITIES 
Management and Supervisory Responsibilities

• Lead and develop the Claims Billing Coordinator Group. 
• Foster a collaborative, innovative, results driven environment by providing on-going mentoring and training.
• Accountable for ensuring that appropriate Claims Billing policies and procedures (internal controls) are in place to provide reasonable assurance that company assets are protected, and to meet compliance standards.
• Maintain Billing Coordination Manual memorializing billing processes, in collaboration with Senior Billing Coordinator II.
• Work with Senior Billing Coordinators I & II to clarify expectations, discuss their progress and concerns, establish objectives and developmental plans, and offer ongoing support and coaching.
• Work with Claims staff (attorneys and analysts) to resolve payment issues and ensure compliance with Billing Standards.
• Utilize standard accounting industry KPIs for accounts payable and accounts receivable to measure group and staff performance.
• Participate as needed in claims management meetings and claims administration system meetings.
• Conduct group trainings as needed.

 
Oversight of Claims Billing Coordination

• Oversee the timely and accurate disbursement of funds in compliance with Department policies and procedures.
• Responsible for issuance of deductible invoices and collection efforts, including closely monitoring the automated process.
• Facilitate the speedy resolution of issues escalated by billing staff, reported by Claims Management, or reported other departments.
• Ensure that accurate and complete vendor records are maintained in Salesforce.
• Coordinate new-hire trainings, and Department refresher and new process trainings.

 
Claims Billing System Management

• Evaluate and make changes to billing processes in our claims management system as needed.
• Identify and report needed repairs to our claims management system, and initiate enhancements.
• Collaborate with IT, Underwriting, and Product Development to minimize adverse impacts to Claims financial data caused by repairs and enhancements to our claims management system.

 
Sole Responsibilities

• Payment voids.
• Deposit deductible payments.
• Maintenance of ProResponse reports.
• Review overrides.
• Application of interest in our claims management system for late deductible reimbursement payments.
• Provide weekly and monthly accounts receivable and collections reports to AVP.

 
Metrics Reports and Data Analytics

• Provide ad-hoc reporting as requested or necessary to support business decisions. 
• Develop KPIs specific to UE’s Claims Billing processes to measure staff performance.
• Collaborate with IT to enhance current metrics reports and develop new reports for Department use.
• Participate in company-wide data analytics strategic planning.

 
Compliance

• Serve as liaison to Accounting and other departments issues concerning Claims financial data, including audits and special projects/requests
• Assist with daily reconciliation between our claims management system and Accounting system; as well as monthly PDOX reconciliation with Accounting, Actuary, and IT departments.
• Responsible for completion of Federal and State tax reporting required by government regulations, including the preparation and issuance of 1099’s in a timely and accurate manner.
• Responsible for preparing selected Claims files for financial auditors.
• Responsible for completion of Medicare Secondary Payer reporting to CMS.

**        The  above-referenced position summary is a guideline designed to present an overview of job duties and is not intended to be a comprehensive list of responsibilities and requirements.