About Tres Health
Tres Health is redefining healthcare with innovative solutions aimed at transforming the industry. The company specializes in providing nationwide ACA-compliant alternative health plans, supplemental GAP insurance, and advanced digital health technologies. Committed to elevating access to quality care while driving cost-efficiency, Tres Health delivers solutions designed to meet diverse needs. The organization is dedicated to creating impactful healthcare models that empower individuals and organizations alike.
Overview
We are seeking a Billing Operations Specialist to support the configuration, administration, and ongoing maintenance of billing operations across multiple systems. This role plays a critical part in ensuring the accuracy of billing configurations, invoice generation, cash application, accounts receivable activities, reconciliation processes, and overall operational support.
The Billing Operations Specialist will work closely with the Implementation, Billing, Finance, and Client Service teams to support accurate group setup, invoice production, payment processing, issue resolution, and process improvement initiatives. This individual will serve as a cross-functional resource, providing operational support across billing and finance functions while assisting with special projects and evolving business needs. The ideal candidate is highly detail-oriented, technically proficient, adaptable, and capable of managing multiple priorities within a fast-paced environment.
Billing Configuration & Maintenance
- Execute billing configuration setup and maintenance across multiple systems
- Build, maintain, and audit:
- Group billing structures
- Plan configurations and eligibility alignment
- Rate tables and premium calculations
- Vendor fee schedules
- Payment arrangements and billing rules
- Enter and update:
- Rates and plan changes (new business, renewals, mid-year updates)
- Billing contacts and invoice recipients
- Special billing arrangements and structures
- Support ACH setup and maintenance for client and vendor payment configurations.
- Validate data accuracy and identify discrepancies prior to invoice generation.
- Troubleshoot and resolve configuration-related issues impacting billing outputs.
Invoicing & Accounts Receivable
- Support invoice generation and invoice audits to ensure billing accuracy.
- Review and validate invoice data prior to release.
- Monitor outstanding receivables and assist with collections activities.
- Follow up with clients, brokers, and internal teams regarding outstanding invoices, billing discrepancies, and payment-related inquiries.
- Research and resolve billing disputes and account discrepancies.
Cash Application & Reconciliation
- Apply incoming payments accurately across billing systems.
- Research unapplied cash, payment variances, and reconciliation discrepancies.
- Assist with monthly and ad hoc reconciliation activities.
- Reconcile invoice, payment, and adjustment activity across systems and reports.
- Support audit requests and financial reporting needs by maintaining accurate records and documentation.
Operational Support
- Follow established processes, controls, checklists, and documentation standards.
- Identify process improvement opportunities and recommend operational efficiencies.
- Assist with testing, system enhancements, and implementation of new billing functionality.
- Maintain strong documentation of billing processes, configurations, and procedures.
- Support special projects, process improvement initiatives, system implementations, testing activities, and other operational responsibilities as assigned.
- Provide cross-functional support across billing, finance, and operations functions as business needs evolve.
Qualifications
- 2–5+ years of experience in billing operations, accounts receivable, insurance operations, finance operations, or a related environment.
- Experience working with billing systems, accounting systems, or administrative platforms.
- Strong analytical and problem-solving skills.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
- Excellent attention to detail and commitment to accuracy.
Required Skills
- Advanced Excel skills, including VLOOKUP/XLOOKUP, pivot tables, data validation, filtering, and reconciliation of large datasets.
- Strong system aptitude with the ability to navigate and work across multiple platforms simultaneously.
- Experience configuring and maintaining billing, insurance, finance, or administrative systems, including setup of rates, plans, billing rules, payment structures, and related system parameters.
- Experience performing data audits, reconciliations, and issue resolution.
- Strong written and verbal communication skills.
- Ability to communicate professionally with clients, brokers, vendors, and internal stakeholders.
- Strong organizational and time management skills.
Preferred Qualifications
- Experience in health insurance, employee benefits, TPA operations, premium billing, or related industries.
- Experience supporting ACH payment processes and cash application activities.
- Experience with system implementations, configuration management, or process improvement initiatives.
- Familiarity with invoice generation, accounts receivable workflows, and reconciliation processes.
Work Schedule & Travel
Full-time, remote position aligned with U.S. business hours. Flexibility required for critical project deadlines, cross-functional meetings, and occasional travel (0–10%) for team collaboration or vendor engagements.
Remote Work Requirements
- Dedicated home office with reliable, high-speed internet.
- Secure workspace aligned with HIPAA security standards (device encryption, secure Wi-Fi, screen privacy).
- Ability to effectively coordinate and lead projects in a fully remote environment.
Security, Privacy & Compliance
This position requires adherence to Tres Health’s security and privacy policies, including HIPAA compliance. All employees must complete security training and comply with access management protocols.
Physical Requirements
- Prolonged periods of sitting and working at a computer.
- Ability to communicate effectively through video, phone, and written platforms.
- Ability to effectively use computers, video conferencing tools, and other standard remote work technology.
- Visual and auditory capabilities suitable for remote work.
- Ability to occasionally lift up to 15 pounds.
Tres Health is committed to ADA compliance and will provide reasonable accommodations to individuals as needed.
Employment Status
This position is governed by at-will employment, meaning either the employee or Tres Health may end the employment relationship at any time, with or without cause or notice, as permitted by law.
EEO & Reasonable Accommodation
Tres Health is an Equal Opportunity Employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other protected category. Tres Health provides reasonable accommodations to enable individuals with disabilities to perform the essential functions of the role. This description is not intended to list all duties or qualifications and may be updated at any time.