Billing Operations Specialist

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.