Premium Billing & Reconciliation Analyst I

Martin's Point Health Care Inc.; New York (NY); On-site; USD 31,000 - 38,000; Full time

Job summary

Martin's Point Health Care in Maine is seeking a Premium Billing Reconciliation Specialist to ensure accurate billing data and strict adherence to Medicare, DOD, and state enrollment rules. You will oversee member profile management and data reconciliation to support clean, compliant billing.

Join our not-for-profit team and collaborate with Accounting and Finance to optimize billing processes, produce standard and ad hoc reports, and assist in audits.

Qualifications

• High School Diploma required; post-secondary education preferred.
• 2+ years of health plan enrollment or billing experience.
• Experience with plan enrollment and supporting systems.
• Experience with Managed Care eligibility processes and systems.
• Strong analytical skills; proficient with Excel; excellent communication.
• Detail oriented with strong follow-up skills.
• Ability to work a flexible schedule, including weekends/holidays when necessary.

Responsibilities

• Maintain expertise in premium billing knowledge.
• Serve as learning resource on premium payment processing.
• Collaborate with Accounting and Finance to respond to member premium requests.
• Meet or exceed department accuracy and productivity goals.
• Identify process gaps and lead improvement activities.
• Prepare standard work and ad hoc reports.
• Manage daily billing posting and payment processing.
• Ensure timely and compliant billing of members.
• Support audits and corrective action plans.

Skills

Exceptional analytical skills

Excellent communication skills

Detail oriented

Flexible schedule

Education

High School Diploma

Post-Secondary Education preferred

Tools

Microsoft Excel

Job description

Martin's Point Health Care in Maine is seeking a Premium Billing Reconciliation Specialist to ensure accurate billing data and strict adherence to Medicare, DOD, and state enrollment rules. You will oversee member profile management and data reconciliation to support clean, compliant billing.

Join our not-for-profit team and collaborate with Accounting and Finance to optimize billing processes, produce standard and ad hoc reports, and assist in audits.