Healthcare Member Premium Billing Team Lead

Who We Are:

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are:

UST HealthProof is looking for a highly energetic and collaborative Billing Team Lead. The Billing Team Lead oversees all aspects of Member Premium Billing operations, including processing, analysis, and reporting of member premium bill information. This role ensures the accurate creation and distribution of member invoices, manages premium bill delinquency and disenrollment processes, and provides oversight of production teams to ensure adherence to service-level agreements (SLAs). The position also produces month-end billing reports and supports continuous process improvement initiatives.

The Opportunity:

• Provides oversight and direction to production teams to ensure Member Premium Billing activities are completed accurately and on time.
• Works closely with production teams to ensure timely and accurate processing of premium billing activities.
• Identifies process issues as they arise and initiates requests for technical analysis and remediation through JIRA.
• Supports and participates in system testing, requirements gathering, and operational readiness updates driven by system enhancements and CMS software releases.
• Responds to inquiries from clients in a timely and professional manner.
• Oversees and reconciles premium payment methods (e.g., SSA, ACH, etc.).
• Prepares, reviews, and analyzes premium payment information for accuracy and completeness.
• Produces month-end billing reports and supports reconciliations, member refund processing, and delinquency/disenrollment activities as required.
• Assists with preparing regulatory reports and statements for management and external parties (e.g., auditors, customers, CMS).
• Participates in internal and external audits as required.
• Attends daily, weekly, and monthly billing-related meetings to stay aligned with operational priorities.
• Drafts policies and develops desk-level procedures to ensure clarity in departmental practices and strong internal controls.
• Interfaces effectively with internal departments, leadership, and external stakeholders.
• Responds to ad hoc requests and performs additional duties as assigned by management.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need:

• Bachelor's degree or higher in any field, or an equivalent combination of education, training, and relevant professional experience that demonstrates the ability to perform the role effectively.
• Bachelor's Degree in Accounting, Finance or related field preferred.
• Minimum 3 years of experience in a related field; premium billing in Healthcare insurance payor sector preferred.
• Prior leadership or team lead experience strongly preferred.
• Strong analytical, organizational, and problem-solving skills.
• Proven ability to communicate effectively-both verbally and in writing.
• Knowledge of Medicare Advantage processes and CMS guidelines.
• Proficiency in standard business applications (e.g., Excel, Word).
• General knowledge of Generally Accepted Accounting Principles (GAAP).
• Ability to manage multiple priorities and work independently or within a team environment.
• Strong interpersonal skills with the ability to engage effectively with internal and external stakeholders.
• Ability to work under general supervision while meeting strict deadlines.
• Excellent written and verbal communication skills to present financial information clearly to both technical and non-technical audiences.
• Strong analytical and problem-solving skills with the ability to identify, analyze, and resolve complex business issues.

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

Role Location: Remote

Compensation Range: $49,000-$57,000

Healthcare,Billing,Billing Process