Note: The job is a remote job and is open to candidates in USA. Pinnacle Technology is seeking an experienced Medicare Advantage Premium Billing Analyst to support premium billing operations for a leading healthcare organization. The role focuses on billing processing, reconciliation, payment investigations, member inquiries, CMS compliance, reporting, audits, and process improvement while collaborating with cross-functional teams.
Responsibilities
- Process and support Medicare Advantage premium billing activities
- Investigate and resolve premium billing discrepancies and payment issues
- Perform premium billing reconciliations to ensure accurate member accounts
- Research and resolve member premium inquiries
- Review and analyze Medicare billing data for accuracy and compliance
- Collaborate with Enrollment, Finance, Customer Service, and Operations teams
- Maintain compliance with CMS regulations and Medicare billing requirements
- Support reporting, audits, and process improvement initiatives
Skills
- • 3–5+ years of experience in a Medicare Health Plan or Managed Care environment
- • Hands-on experience with Medicare Advantage premium billing
- • Experience investigating premium payment discrepancies and account reconciliation
- • Knowledge of CMS billing regulations
- • Experience supporting Medicare membership and enrollment-related billing
- • Strong analytical and problem-solving skills
- • Proficiency with Microsoft Excel and Microsoft Office
- • Excellent written and verbal communication skills
- • Experience working with CMS files
- • Experience with California DHS (CA DHS) files
- • Finance, accounting, or bookkeeping experience
- • Experience supporting Medicare billing audits and compliance initiatives
Benefits
- Fully Remote
- Long-term 32-week contract
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