Mgr, Traditional Billing

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us.

We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds.

The primary responsibility of this position includes oversight of multiple billing and enrollment teams, ensuring that we deliver timely and accurate bills and enrollment completion to our customers, in addition to properly reporting revenue. This position is responsible for managing the account receivables and invoice reconciliation process, responding to internal and external regulatory audits, payment posting re-allocation, premium collection effort and manual and electronic enrollment in addition to managing high profile account delinquency and recouping and collecting premium payments.

Execute monthly, quarterly and yearly revenue reports and partner with Finance on premium and general ledger tasks. Responsible for month-end, quarterly and year-end financial close for commercial and all fully insured group accounts. This role is accountable for the yearly rate renewal process and quality controls for the Medigap population while overseeing Medicare billing and premium rate validation process. This responsibility is accountable for the revenue and premium collection process for the commercial market where the annual revenue exceeds $4B.

• Continuously evaluate and analyze business processes and workflows to identify opportunities for operational improvement, increased efficiency, and cost reduction.
• Lead process improvement initiatives through root cause analysis, technology assessments, and workflow optimization.
• Manage projects that enhance processes and systems in partnership with IT, internal stakeholders, and external customers.
• Maintain effective internal controls to ensure the accuracy and completeness of financial transactions and reporting.
• Ensure compliance with applicable laws, regulations, policies, and operational standards.
• Manage departmental operating expenses, including salary and non-salary costs, within approved budgets.
• Oversee collection activities, enforce collection policies, and manage delinquent accounts in accordance with legal and regulatory guidelines.
• Lead, develop, and mentor supervisors and staff responsible for premium billing and collection functions.
• Build and maintain strong relationships with brokers, sales teams, customers, and other key stakeholders through effective communication and timely issue resolution.
• Strengthen internal controls to prevent financial errors, revenue leakage, and material misstatements.
• Represent the billing department in corporate projects and strategic initiatives, ensuring business requirements are effectively communicated and addressed.
• Collaborate with internal and external stakeholders to resolve billing, payment, and customer service inquiries.
• Ensure accurate monthly revenue reporting by reviewing, reconciling, and communicating premium collection activities to Finance.
• Maintain compliance with all required training, reporting, accreditation, and regulatory requirements.
• Develop and maintain strong cross‑functional business partnerships while representing the premium billing department across the organization.
• Partner with external vendors to monitor…