Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

The Manager of Premium and Billing is responsible for the daily workload balancing of the team, initiating and implementing key departmental initiatives for all lines of business including Commercial, Exchange, ASO and Medicare within the established standards for quality, quantity, and timeliness.  Demonstrates and transfers product and process knowledge to Premium Billing Lead and SMEs with a focus on continuous learning and leadership development.  Drives quality and production outcomes to meet departmental/organizational metric standards and expectations while also maintaining compliance with all regulatory requirements. S/he supervises production and project deliverables independently, provides leadership to staff, supports training of new functions/processes and escalates issues appropriately.

• Drive continuous improvement in system capabilities and processes for billing and collection efforts focused on producing timely and accurate bills, and management of department metrics.
• Be the subject matter expert on special projects or implementation work as it relates to the Premium Billing cycle, downstream impacts, and integrations.
• Improve, monitor and enforce billing policies and procedures, and ensure they evolve appropriately as the company scales.
• Develops and maintains business relationships through effective and timely communication.
• Serves as customer escalation and resolution point for invoicing issues and disputes.
• Reviews and interprets operational data to assess need for procedural revisions and enhancements.
• Supervises, trains, and ensures staff is knowledgeable on all billing systems.
• Mentors and coaches staff by providing on-going training as necessary to assure communication of common issues/concerns.
• Assists with preparation of annual departmental FTE and operating expense budget. Assists in strategic planning, including business objectives, goal-setting sessions.
• Monitors productivity standards and directs staff in meeting the defined departmental goals and objectives.
• Other duties as assigned

Qualifications:

• Bachelors Degree in Accounting, Finance, or Business Administration required.
• Requires a minimum of five years of experience in a medical/insurance field, preferably in Premium Billing or related financial areas, three of which must have been in a supervisory capacity.
• Demonstrated ability to communicate effectively in person, via telephone and in writing with peers, subordinates, employers, brokers, individual members, and representatives from Federal and State regulatory entities.
• Excellent organizational skills and ability to function well under stress.

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services