Senior Health Plan Client & Billing Specialist

Horizon Blue Cross Blue Shield of New Jersey; Newark (NJ); On-site; USD 98,000 - 133,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement plans

Generous PTO

Incentive plans

Wellness programs

Paid volunteer time off

Tuition reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking an experienced professional to provide subject matter support to the SHBP account management teams. The role emphasizes building strategic relationships with market stakeholders and driving profitability and revenue growth.

You will oversee billing operations, forecast performance, coordinate vendor integrations for State members, and assist in plan design implementations. A bachelor’s degree and 10+ years in group health are required.

Qualifications

• Prefers a Bachelor’s degree from an accredited college or university.
• Requires a minimum of 10 years of experience in group health.
• Experience managing in a fast paced, performance driven environment necessary.
• Knowledge of complex billing operations preferred.

Responsibilities

• Provides subject matter support to the account management teams in areas related to underwriting, ancillary products, benefit design, and market-specific dynamics.
• Serve as the subject matter expert for billing operations, ensuring accurate billing administration and timely resolution of billing inquiries and discrepancies.
• Maintain accurate and updated billing master roster.
• Develop and maintain monthly, quarterly, and annual forecasts, identifying trends, variances, risks, and opportunities impacting financial performance.
• Support of plan design implementations, ensuring accurate translation of State legislation into business requirements.
• Act as the business lead for vendor integrations serving State members.
• Serves as a liaison for account management team and other support areas within the organization that impact client management.
• Manage database of individual stakeholders within the market and their connections.
• Provides assistance in developing strategic business plan to retain and grow within the SHBP Plan.
• Train newly hired staff on the unique SHBP Market.

Skills

Billing operations

Forecasting

Vendor integrations

Stakeholder management

Underwriting basics

Education

Bachelor's degree

Tools

Windows OS

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking an experienced professional to provide subject matter support to the SHBP account management teams. The role emphasizes building strategic relationships with market stakeholders and driving profitability and revenue growth.

You will oversee billing operations, forecast performance, coordinate vendor integrations for State members, and assist in plan design implementations. A bachelor’s degree and 10+ years in group health are required.