Senior Specialist, Premium Billing (Must Reside in WI)

Knowledge/Skills/Abilities u2022 Process daily enrollee's (Individual and family) invoices and premium reconciliation for Marketplace members. u2022 Reconcile premiums received from the individual subscriber or responsible party with the amount due for the healthcare program the member is enrolled. u2022 Guide and support Member Service representatives to help them resolve member inquiries related to healthcare premium. u2022 Assist in resolution for escalated premium issues with Appeals and Grievances team members. u2022 Guide and collaborates with enrollment team to resolve eligibility issues affecting premium billing. u2022 Generate billing data using the QNXT premium billing module to be sent to print and fulfillment vendor. u2022 Reconcile unallocated payments on a daily basis. u2022 Resolve orphan member payments on a daily basis. u2022 Reconcile monies received from the financial institution. u2022 Perform month-end invoicing and accuracy audits. u2022 Comply with all State/Regulatory requirements.Under limited supervision, drives and supports reconciliation of premiums for members enrolled though the Healthcare Marketplace as a part of the Affordable Care Act (ACA). Reconciliation will be performed for more complex premiums received from members, state agencies and CMS. Team member will work closely with enrollment teams and offer guidance where premiums are directly impacted by enrollment discrepancies. Collaborate with and advises call center teams to maintain member satisfaction for this product. Work with financial institutions to ensure timely and accurate processing of payment received.u2022 Marketplace, Commercial, or Medicare healthcare experience with premium billing and reconciliation. u2022 Must have excellent time management and organizational skills. u2022 Strong team-oriented individual. u2022 Excellent communication with all levels of team. u2022 Must have strong knowledge and experience in MS office products, minimally Outlook, Word and Excel. u2022 Access or SQL experience is a plus. u2022 Excellent verbal and written communication skills. u2022 Ability to abide by Molina's policies. u2022 Maintain regular attendance based on agreed-upon schedule. u2022 Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). u2022 Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.. Job Qualifications Required Education High School diploma required Required Experience 3+ years of Member Billing /R Required License, Certification, Association Marketplace, Commercial or Medicare Industry preferred Required Licensure/Certification: None Preferred Education Associates Degree or higher preferred Preferred Experience Healthcare industry experience, with emphasis on enrollment, member billing, and premium reconciliation preferred. Preferred License, Certification, Association None To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $14.9 - $29.06 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-12-05