Strategic Health Plan & Billing Liaison

100 Horizon Healthcare Services, Inc; Newark (NJ); On-site; USD 98,000 - 133,000; Full time

Benefits offered by this job

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 support SHBP account management teams. You will focus on strategic relationships, billing operations, and translating state legislation into business requirements.

This role aims to increase profitability, expand membership, and revenue. The position requires a Bachelor's degree and 10+ years in group health, with strong analytical skills and experience in a fast-paced environment.

Qualifications

• 10+ years of experience in group health.
• Experience in a fast-paced, performance-driven environment.
• Knowledge of complex billing operations preferred.
• Proficient with PCs and Windows-based software.
• Knowledge of health insurance plans, delivery systems, and claims.

Responsibilities

• Provide subject matter support to account management teams on underwriting, ancillary products, benefit design, and market dynamics.
• Serve as SME for billing operations and resolve billing inquiries and discrepancies promptly.
• Maintain billing master roster and accuracy of data.
• Develop and maintain forecasts (monthly, quarterly, annual) highlighting trends, variances, risks, and opportunities.
• Support plan design implementations translating State legislation into business requirements.

Skills

Group health experience

Billing operations

Pricing & underwriting principles

Windows software proficiency

Health insurance knowledge

Education

Bachelor's degree

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking an experienced professional to support SHBP account management teams. You will focus on strategic relationships, billing operations, and translating state legislation into business requirements.

This role aims to increase profitability, expand membership, and revenue. The position requires a Bachelor's degree and 10+ years in group health, with strong analytical skills and experience in a fast-paced environment.