Administration Specialist - Eligibility/Billing

Location: St. Petersburg, FL

Summary

The Administration Specialist coordinates and manages all aspects of new business set-up, premium billing, collection, distribution, eligibility, fund accounting, check printing and policy issue/fulfillment.

Essential Duties and Responsibilities:

  • Achieves and maintains goals and objectives per state mandates, program and carrier requirements and company standards
  • Monitors quality assurance program to ensure that company quality objectives are met
  • Reviews and keeps abreast of applicable program, plan and policy provisions
  • Assists in the development of training programs and Policies and Procedures
  • Sets up and maintains new/renewal groups in system and fund accounts
  • Processes premium distributions to carriers, agents, providers and vendors
  • Processes eligibility and ensures accuracy of data transmitted
  • Ensures the accuracy and timeliness of monthly premium statements
  • Oversees the process of claim check printing including voiding and reissuing of checks
  • Coordinates with print vendor assuring accuracy of printed documents
  • Over site of banking positive pay process, reviewing exceptions, issuing stop pays, checking status
  • Reconciliation of bank accounts
  • Process provider/member refunds
  • Processes numerous reports, daily, weekly and monthly for internal and external reporting

Other Responsibilities:

  • Adheres to the policies and procedures of Premier Administrative Solutions
  • Maintains strict confidentiality of client, company and personnel information
  • Demonstrates a strong commitment to the mission and values of the organization
  • Adheres to company attendance standards
  • Performs other duties as assigned

Supervisory Responsibilities:   None

Competencies:

  • Strong organizational and interpersonal skills
  • Excellent written and verbal communication skills
  • Detail oriented
  • Ability to multi-task and work independently

Qualifications:

A minimum of one to two (1-2) years of Billing/Accounting and Eligibility Processing experience in the health insurance industry is preferred.

Education and/or Experience:

A Bachelor’s degree or equivalent amount of industry experience is preferred.

Certificates, Licenses, Registrations:

None

Computer Skills:

Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook

Environmental Factors/Physical Demands:

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

To apply, please forward resume to careers@chsamerica.com

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