Premium Billing Analyst (Healthcare

Why join the Novacore team?

Because your next stellar chapter starts here — and we’re building something bold and meaningful. At Novacore, we’re not your average insurance company. We’re a team of driven professionals passionate about redefining the specialty insurance experience for our agents, carrier partners — and for each other. We specialize in tailored solutions for niche industries, powered by advanced analytics, modern technology and a culture of innovation.

Backed by strong leadership and strategic growth initiatives, Novacore is poised to scale and lead in the specialty insurance market. But at our core, we believe it’s not just what we do — it’s how we do it and who we do it with. Recognized as a top workplace, Novacore is a place where ambition is supported, growth is continuous and culture matters.

From day one, you’ll find mentorship, hands‑on learning and clear paths for advancement. You’ll grow your skills, expand your expertise and become even more exceptional — because when you succeed, we all do. We offer: A collaborative, results‑driven environment Competitive compensation and comprehensive benefits Year‑round social and community events Ongoing mentorship and professional development Endless opportunities for upward mobility So if you're ready to be part of something extraordinary — with a team that’s transforming commercial insurance — we want to meet you.

The Managed Care Premium Analyst plays a pivotal role in the administration and management of premium billing functions within the Managed Care program at Carbon Stop Loss Solutions. This position is responsible for ensuring accurate and timely billing for managed care products including HMO, PPO, EPO, and self‑funded health plan arrangements, resolving complex billing issues, collaborating with underwriting, claims, network management, and accounting teams, and providing exceptional service to clients and carrier partners.

The ideal candidate will have a strong background in managed care premium billing and health plan administration, excellent analytical skills, and the ability to manage multiple priorities while working independently.

• Premium Billing Management:
  Oversee and process monthly premium billings for managed care products (HMO, PPO, EPO, CDHP) and self‑funded health plan arrangements, ensuring accuracy and timeliness.
• Review and analyze complex premium data, including composite and age‑banded rating structures, adjusting for enrollment changes, plan design amendments, carrier rate changes, and mid‑year renewals.
• Administer premium remittance to carrier partners and reinsurers, ensuring proper allocation across multiple funding arrangements (fully insured, level‑funded, and self‑funded).
• Collaborate with internal teams and outsourced partners to ensure premiums are billed accurately based on current enrollment data, benefit plan details, and carrier contract terms.
• Enrollment & Eligibility Administration:
  Process and validate member enrollment and eligibility data received from employer groups, ensuring accurate subscriber and dependent counts are reflected in monthly billings.
• Manage retroactive enrollment adjustments and retroactive terminations, calculating and applying premium credits or back‑billings as appropriate.
• Coordinate with carrier partners to confirm eligibility file transmissions and resolve discrepancies between internal records and carrier enrollment rosters.
• Client Communication & Support:
  Serve as the primary point of contact for employer groups and brokers regarding premium billing inquiries, enrollment discrepancies, and payment issues specific to managed care products.
• Provide clear, timely, and professional communication regarding billing statements, premium adjustments, payment schedules, and grace period policies in accordance with managed care contract terms.
• Assist clients in understanding billing statements, rate structures, dependent tier categories, and payment schedules across multiple managed care plans offered under their group contracts.
• Reconciliation & Reporting:
  Perform reconciliation of premium payments against carrier…