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Specialty Billing Representative

Job in Lansing, Ingham County, Michigan, 48900, USA
Listing for: Blue Cross Blue Shield of Michigan
Full Time position
Listed on 2026-09-12
Job specializations:
  • Insurance
    Financial Analyst
Salary/Wage Range or Industry Benchmark: 52000 - 78000 USD Yearly USD 52000.00 78000.00 YEAR
Job Description & How to Apply Below

SUMMARY

Level I is in a learning capacity and will progress to the senior level when the incumbent qualifies and is able to provide coverage and assistance across all primary responsibilities and focus areas independently.

This job is primarily responsible for products and services underwritten by the Enterprise that require manual processes due to the complex nature of the request or system limitations. Performs in-house collection activity that ultimately determines financial resolution of delinquent funds owed to the Enterprise. Services, bills and manages tasks related to "specialty" (i.e. Loss Sensitive, Accu Premium) business underwritten by the Enterprise.

Calculates commission owed to agencies on a monthly basis and handles all servicing related to agency commissions. Contacts include:
Enterprise employees, agents and policyholders, external collection agencies, NCCI and legal representatives.

PRIMARY RESPONSIBILITIES
  • Maintains in-depth knowledge of policy and commission structure of each brand within the Enterprise.
  • Completes manual commission calculations for the individual brands within the Enterprise. Creates statements and check requests to pay commissions on a monthly basis.
  • Manually calculates and bills for retrospective premium adjustments and monthly losses related to loss sensitive business for all brands within the Enterprise.
  • Monitors and tracks collateral to ensure loss funds are adequately funded.
  • Works directly with policyholders and external collection agencies in regards to past due balances. Uses authority levels to make decisions in regards to balances due.
  • Monitors aging reports and completes follow-ups with Premium Audit, Underwriting and Management.
  • Reviews, negotiates and approves payment arrangements and settlement offers on past due receivables for the Enterprise.
  • Files bankruptcy claims with the Bankruptcy Court for policyholders that have entered bankruptcy. Has an understanding of the different types of bankruptcy and how to appropriately handle each.
  • Participates in the development of requirements related to new Enterprise wide systems.
  • Verifies reasonableness of data in ancillary and disparate systems.
  • Reconciles accounts to clarify billing transactions and cash application in order to provide customers with up-to-date account information/history.
  • Responds to internal and external customer requests via telephone or electronic correspondence. Correspondence is drafted as requested to address complaints or information requests. Requests are initiated by agents, policyholders, underwriters, or management.
  • Processes pay by phone transactions to expedite posting of cash to insured's policy.
ADDITIONAL RESPONSIBILITIES FOR THE LEVEL II
  • Provides coverage and assistance across all primary responsibilities and focus areas.
  • Provides training and mentoring to the Level 1 Specialty Billing Representative position.
  • Addresses and responds to complex internal and external customer requests.
  • Works with minimum supervision.
EMPLOYMENT QUALIFICATIONS

A.

EDUCATION REQUIRED:

(Brief paragraph detailing the minimum education required, including certifications) Do not state preferred qualifications.

Minimum of an Associates degree in Business or equivalent. Combinations of relevant education and work experience may be considered in lieu of degree.

B. EXPERIENCE

REQUIRED:

Minimum of three (3) years experience in billing, underwriting, policy processing or equivalent work which provides the necessary skills, knowledge and abilities.

OR

Bachelor's degree in Business or equivalent and 1 year of relevant experience in billing, underwriting or policy processing. Combinations of relevant education and work experience may be considered in lieu of degree.

ADDITIONAL EXPERIENCE REQUIRED FOR THE LEVEL II:

Minimum of five (5) years experience in billing, underwriting, policy processing or equivalent work which provides the necessary skills, knowledge and abilities.

OR

Bachelor's degree in Business and 3 years of relevant experience in billing, underwriting or policy processing.

C. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED
  • Basic knowledge of workers compensation.
  • Knowledge of claims and underwriting operations (i.e. deductibles, billing etc.,)/
  • Ability to analyze details of policy billing and payment data and, based on this analysis, make efficient and effective independent decisions within authority.
  • Ability to analyze details of policy billing and payment data and, based on this analysis, make efficient and effective independent decisions within…
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