Premium Billing and Reconciliation Program Manager

Genesis10 is currently seeking a Premium Billing and Reconciliation Program Manager for a 3+ month contract role in the healthcare industry in Raleigh, NC. This role is hybrid.

Compensation: Hourly W2 pay: $70.00 to $80.00/hour

Description:

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.

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 support their ability to manage complex billing and eligibility workflows.

Travel to North Carolina - 0-25%. May require travel once a week.

Required Skills:

• Premium Billing and Reconciliation Program Manager:
• Experience in writing and evaluating RFPs
• Group and individual health plan premium billing and reconciliation
• Provide support with reconciling premiums based on eligibility information against billed amounts, identifying variances, and resolving discrepancies
• Provide support with investigating and resolving premium mismatches, duplicate entries, and missing data
• Provide support with the monthly reconciliation of membership data between:
• Eligibility, billing, and Medicare Advantage vendors.
• Eligibility, billing, and TPA vendors
• Maintain documentation and suggest process improvements
• Some experience with Electronic Data Interchange (EDI)
• Some understanding of COBRA Administration
• Some experience with vendor implementation
• Provide support managing the end-to-end relationships with assigned vendors
• Strong problem-solving abilities and experience with analysis tools and techniques (such as Excel and Smartsheet)
• Basic understanding of financial reporting, audit trails, and data reconciliation techniques.
• Mentorship to team members to help with their professional growth
• Strong analytical and problem-solving skills, especially in identifying and resolving billing discrepancies.
• Excellent communication and collaboration skills, especially when working with multiple vendors

We have access to additional contract, contract-to-hire, and direct hire positions with various rate ranges.

If you have the qualifications described and are interested in this exciting opportunity, apply today!

Ranked a Top Staffing Firm in the U.S. by Staffing Industry Analysts for six consecutive years, Genesis10 puts thousands of consultants and employees to work across the United States every year-in contract, contract-for-hire, and permanent placement roles. With more than 300 active clients, Genesis10 provides access to many of the Fortune 100 firms and a variety of mid-market organizations across the full spectrum of industry verticals.

Benefits of Working with Genesis10:

• Access to hundreds of clients, most of whom have been working with Genesis10 for 5-20+ years.
• The opportunity to have a career-home in Genesis10; many of our consultants have been working exclusively with Genesis10 for years.
• Access to an experienced, caring recruiting team (more than 7 years of experience, on average).
• Medical, Dental, Vision
• Health Savings Account
• Voluntary Hospital Indemnity (Critical Illness & Accident)
• Voluntary Term Life Insurance
• 401K
• Sick Pay (for applicable states/municipalities)
• Commuter Benefits (Dallas, NYC, SF, and Illinois)
• Remote opportunities available

For multiple years running, Genesis10 has been recognized as a Top Staffing Firm in the U.S., as a Best Company for Work-Life Balance, as a Best Company for Career Growth, for Diversity, and for Leadership, amongst others. To learn more and to view all our available career opportunities, please visit our website.

Genesis10 is an Equal Opportunity Employer. Candidates will receive consideration without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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