Fallon Health

  • Billing Representative with Growing Local Health Insurance Company!

    Location US-MA-Worcester
    Posted Date 2 months ago(3/6/2018 4:46 PM)
    Job ID
    # Positions
    Enrollment & Billing
  • Overview

    About Fallon Health:

    Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is the only health plan in Massachusetts to have been awarded “Excellent” Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.


    Position Overview:

    Performs all functions necessary to maintain accurate subsidiary accounts receivable, and ensure accuracy of premium bills. Reconciles employer group bills to group payment listings or direct pay member bills, and reports discrepancies to Enrollment Operations staff for further research. Reviews monthly Accounts Receivable Summary and Aged Trial Balance to identify problems with payments, etc.



    • Interacts with employer groups, members, and internal customers on a daily basis; answers questions and resolves problems.
    • Prepares manual adjustments as necessary.
    • Collects premium for employer groups and individual members; including but not limited to written correspondence as well as collection calling for delinquent accounts receivables.
    • Performs reconciliations, both automated and manual, on all employer group and/or direct pay members’ accounts, ensuring accuracy and integrity of premiums billed.
    • Imposes late notices and cancellations on delinquent accounts.
    • Posts payments and adjustments as necessary.
    • Prepares balance forward notification and requests for payment history.
    • Works daily/monthly reports which identify potential problems.
    • Determines allowance for bad debt.
    • Calculates 5500 Schedule A information


    Education: High School Diploma required; College Degree preferred.      

    Experience:  A minimum of 1 – 2 years in HMO or the insurance industry.






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