Eligibility & Billing Coordinator - Technical (Finance)

Summa Health

Cleveland (OH)

Hybrid

USD 39,000 - 58,000

Full time

35 hours ago

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Benefits offered by this job

Basic Life and AD&D

Supplemental Life and AD&D

Dependent Life Insurance

Short-Term and Long-Term Disability

Accident Insurance, Hospital Indemnity

Retirement Savings Plan

Flexible Spending Accounts - Health

Employee Assistance Program (EAP)

Identity Theft Protection

Pet Insurance

Education Assistance

Daily Pay

Job summary

SummaCare is hiring an Eligibility & Billing Coordinator with a focus on Financial Operations. Based in Akron, Ohio, this full-time hybrid role links health plan operations with the financial side of the business, leading premium billing, rates, payments, reconciliation, delinquency, financial controls, and coordination with Finance and Accounts Receivable.

You will investigate discrepancies, identify root causes, and improve cross-team processes.

Qualifications

Associates degree or equivalent education/experience.
Minimum 3 years of technical/analytical experience in healthcare or finance.

Responsibilities

Coordinate daily operations of the Eligibility & Billing technical team.
EDI processing of enrollment and payment transactions and reconciliation of enrollment and payment status.
Auditing and monitoring activities; escalate at-risk assignments as needed.
Support delegation of work, training, and issue resolution; provide daily team support.

Skills

Financial ops

Premium billing

Reconciliation

Accounts receivable

Revenue integrity

Healthcare operations

Analytical skills

Communication

Cross-functional

Education

Associates degree or equivalent

Tools

MS Excel

MS Access

Windows

Outlook

Job description

Hybrid

Do you have experience in financial operations, premium billing, reconciliation, Accounts Receivable, or revenue integrity within health insurance? SummaCare is hiring an Eligibility & Billing Coordinator with a focus on Financial Operations. This role connects health plan operations with the financial side of the business, providing operational leadership across premium billing, rates, payments, reconciliation, delinquency, financial controls, and coordination with Finance and Accounts Receivable.

SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Hybrid

We're looking for someone who enjoys digging into discrepancies, identifying root causes, improving processes, and working across teams to solve complex issues from beginning to end. If your background combines healthcare operations with strong financial and analytical skills, this could be a great next step!

Summary

Coordinates daily operations of the Eligibility & Billing technical team, including EDI processing of enrollment and payment transactions and reconciliation of enrollment and payment status between SummaCare and its clients, vendors and regulatory agencies. Performs auditing and monitoring activities as assigned by Manager. Escalates at-risk assignments to management as needed to ensure all transactions are processed according to established standard for timeliness and accuracy. Assists management with providing support for delegation of work, training, and resolution of issues. Provides daily support to technical team to cover workloads.

Formal Education Required

Associates degree or equivalent combination of education and/or experience.

Experience & Training Required

Three (3) years' experience in technical/analytical functions in healthcare or finance environment.

Other Skills, Competencies And Qualifications

Foster a positive and teamwork oriented environment.
Demonstrate proficiency in eligibility, billing, and accounts receivable functions.
Demonstrate proficiency using Windows, Outlook, Web Browsers and other computer based information management tools as required. (Word, MS Excel and/or Access at intermediate level)
Ability to communicate in a professional manner to a wide variety of audiences, including Senior Leadership. This includes presentations, correspondence, instructional material, reports, policies and procedures, legal and or technical documents. Excellent proofreading skills
Strong analytical skills to review regulatory guidance and create action plans for implementation of new and changing rules. Ability to review data from a variety of sources in order to make recommendations/conclusions based on the outcomes.
Excellent attention to detail and strong trouble shooting skills.
Organize and manage time to accurately complete tasks within designated time frames in fast-paced environment.
Maintain current knowledge of and comply with regulatory and company policies & procedures.
Maintain confidentiality of member health and business information.
Flexible: ability to adjust work hours to meet business demands.

Level Of Physical Demands

Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

Equal Opportunity Employer/Veterans/Disabled

$28.10/hr - $42.15/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.