Premium Billing And Reconciliation Program Manager
The Premium Billing and Reconciliation Program Manager will support group and individual health plan premium billing and reconciliation processes, ensuring accuracy between billed amounts and member eligibility data. They support monthly reconciliation efforts across internal systems and external vendors, including Medicare Advantage and TPA partners, identifying and resolving discrepancies such as premium mismatches, duplicate entries, and missing data. They maintain documentation, suggest process improvements, and will attend daily operational calls while helping to manage end-to-end vendor relationships, based on the direction of the Customer. This includes facilitating access to project deliverables and ensuring collaboration across vendor teams. The role also involves attending regular meetings to track issues, risks, and action items, supporting operational staff on projects and RFPs, and mentoring new members to promote role growth. Familiarity with EDI (data files) and some understanding of COBRA administration further supports their ability to manage complex billing and eligibility workflows.
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