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Billing & Reconciliation ACA Specialist II

Employer
Blue Cross Blue Shield of ND
Location
Fargo, ND
Salary
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Job Details

The Billing, Reconciliation and ACA (Affordable Care Act) Specialist II answers all verbal and written inquires associated to billing and membership and updates membership records for members that have coverage through the Federally Facilitated Marketplace (FFM) with Blue Cross Blue Shield of North Dakota (BCBSND), thus enabling claims to be paid accurately and promptly. The Billing, Reconciliation and ACA Specialist II serves as the primary contact for ACA billing and reconciliation questions.

Essential Functions

  • Researches and analyzes all verbal and written billing and membership inquiries from individual members and internal departments regarding individual member billing/membership data and updates records, as required.
  • Researches and resolves discrepancies reported through electronic files.
  • Performs specialized research, comparing various systems for data discrepancies.
  • Manages billing and membership correspondence from internal and external customers.
  • Documents and retains inquiry documentation under organizational record retention policies.
  • Updates Medicare limits as needed to designate who should be primary payer.
  • Analyzes payments submitted by individuals to balance their accounts receivable.
  • Identifies and resolves discrepancies by communicating with individuals by mail through member services or contacting the billing vendor associate.
  • Makes adjustments to, removes members from coverage or updates member information if appropriate and documents the action taken.
  • Monitors reports for members not billed and sends notification to members as necessary.
  • Enters bank routing numbers and account numbers to individual billing files to ensure proper accounts are debited correctly for ACH billing.


Requirements

Knowledge, Skills and Abilities

Attention to Detail and Accuracy

Basic

Organizational Understanding

Basic

Customer Interaction

Basic

Time and Resource Management

Basic

Continuous Learning/Development (Self)

Basic

Education Requirements

Required: High School Diploma/GED

Preferred: Associate's

Field(s) of Study: Accounting, Business Administration or related field

Experience Requirements

Required: Minimum of 1 Year

Preferred: Minimum of 1 Year

Experience Details: : Minimum of 1 year of accounts receivable, accounts payable, customer service or related experience is required.

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

OTHER INFORMATION

Job Posting Policy 6.05

New employees with Blue Cross Blue Shield of North Dakota will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

EQUAL OPPORTUNITY EMPLOYMENT



Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com

This job posting will be closed 10/4/2018 at 8:00AM CST. No further applications will be considered.

Company

TWO WORDS – MEMBERS FIRST.

That sums up why we’re here. And according to member satisfaction surveys, 95.6% say we’ve done a great job at maintaining that focus.

With that said, there are still mountains to move. America’s health care system needs an overhaul and Blue Cross Blue Shield of North Dakota is taking a lead role. To accomplish that, we need BOLD people who believe they can make an impact.

Are you ready to shake up an industry?

If you’re passionate about taking on our nation’s number one health care concern, there may be a place for you on one of our teams.

Company info
Website
Location
4510 13th Ave. S.
Fargo
ND
58103
United States

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