Billing Operations Specialist

Summary

Tres Health provides nationwide ACA-compliant alternative health plans, supplemental GAP insurance, and digital health technologies. The Billing Operations Specialist will support billing configuration, invoice generation, cash application, accounts receivable, reconciliation, issue resolution, and operational improvements across multiple systems while collaborating with implementation, billing, finance, and client service teams.

Responsibilities

• 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
• 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
• 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
• 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

Skills

• • 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
• • 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
• • 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
• 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
• • 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
• • 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

Qualifications

Must Haves

• • 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
• • 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
• • 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
• 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
• • 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

Nice to Haves

• • 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

Benefits

• Full-time, remote position aligned with U.S. business hours