Enrollment/Billing Lead Representative

The Revenue Account Specialist manages the end-to-end billing relationship. Identify opportunities for process improvements to enhance client satisfaction, the Global Service Partner Relationship, and reduce financial risk and successful implementation of new and renewing clients.

This role is responsible for premium billing and collection, financial reconciliation, issue resolution, risk identification, and client support. The specialist partners with clients and internal teams to deliver a positive experience while protecting the organization’s financial and operational interests.

Success requires strong analytical skills, independent judgment, ownership, and the confidence to professionally challenge requests that fall outside standard processes or create financial, compliance, or operational risk.

Key Responsibilities

·       Manage billing relationships for medical, dental, vision, and other applicable invoices.

·       Support premium billing, payment reconciliation, allocation, collection, and issue resolution.

·       Research discrepancies involving payments, rates, eligibility, commissions, and other billing concerns.

·       Communicate with delinquent clients according to established collection processes.

·       Analyze financial and operational data to identify trends, root causes, financial exposure, and operational risks.

·       Evaluate non-standard requests and identify potential downstream impacts before decisions are finalized.

·       Recommend sustainable alternatives when requests cannot be supported through standard procedures.

·       Lead client, broker, and Third-Party Administrator calls (video) to explain billing processes and resolve concerns.

·       Manage escalations and sensitive client situations with professionalism and urgency.

·       Partner with Sales, Implementation, Underwriting, Finance, Operations, Client Management, Commissions, and other teams.

·       Support new and renewing client implementations by reviewing billing requirements and identifying risks.

·       Identify process gaps and recommend workflow improvements that increase accuracy, reduce manual work, and improve the client experience.

·       Maintain accurate process documentation, client instructions, reporting, and issue tracking.

·       Take ownership of problems through resolution and follow up on outstanding actions.

·       Recommend monthly reserves or accruals to Finance when financial exposure is identified.

Requirements:

·       Technical and Professional Requirements

·       Healthcare billing, insurance operations, premium management, finance, accounting, or related experience preferred.

·       Experience with financial reconciliation and analysis.

·       Advanced Microsoft Office skills, particularly Excel.

·       Ability to analyze complex financial and operational data.

·       Strong root cause analysis and problem-solving skills.

·       Client management or client service experience.

·       Process documentation and workflow improvement experience.

·       Experience supporting non-standard billing arrangements, Self-Billed accounts, Third-Party Administrators, brokers, or complex client structures preferred.

·       Bachelor’s degree in Finance, Accounting, Business Administration, Economics, or a related field preferred.

·       Communication and Business Acumen

·       Exceptional verbal and written English communication skills.

·       Ability to lead client and internal partner meetings on video.

·       Ability to explain complex billing and financial concepts to non-technical audiences.

·       Strong negotiation, influence, and conflict-resolution skills.

·       Ability to professionally challenge assumptions and defend recommendations.

·       Strong critical thinking and independent decision-making skills.

·       Ability to balance customer experience, operational efficiency, and financial risk.

·       Sound judgment when evaluating exceptions to standard processes.

·       Strong ownership, accountability, and follow-through.

·       Ability to influence stakeholders without direct authority and resolve competing priorities.