Billing Configuration Lead

Position Summary

We are seeking a Billing Configuration Lead to own the setup, accuracy, and ongoing management of billing configurations across systems. This role is critical to ensuring invoices generate correctly by building and maintaining group and vendor billing structures, including rates, plans, and payment arrangements.

You will act as the central point of control between implementation, billing operations, and system platforms to ensure data integrity and seamless billing execution.

Essential Duties & Responsibilities

• Configure and maintain billing setups across multiple systems
• Build and manage:
  • Group billing structures
  • Plan configurations and eligibility alignment
  • Rate tables
  • Vendor fee schedules
• Manage ACH configurations for client collections and vendor payments, including complex and non-standard arrangements.
• Ensure alignment and accuracy across systems.
• Oversee all post-implementation changes including new business, renewals, and mid-year updates (rates, plans, billing structure, contacts, special arrangements).
• Partner with internal parties to resolve configuration-related issues impacting invoices, cash application, and disbursements.
• Establish quality control processes to ensure billing accuracy before invoice generation.
• Maintain documentation and standard operating procedures for all configurations.
• Strong process ownership mindset with the ability to identify gaps, create structure, and implement scalable workflows across billing configuration and related operations.
• Other tasks as assigned.

Minimum Qualifications

• 3--6+ years of experience in billing operations, configuration, or finance within a TPA, health plan, or insurance environment.
• Strong understanding of health insurance billing, including rates, eligibility, and premium calculations.
• Experience working across multiple systems and managing data consistency.
• High attention to detail with strong problem-solving skills.
• Advanced Excel skills required, including the ability to analyze, reconcile, and validate large datasets across multiple systems (e.g., VLOOKUP, pivot tables, data comparisons).

Preferred Experience

• Bachelor's degree preferred; equivalent experience strongly considered.
• Experience with billing/admin systems and system integrations (e.g., invoice or eligibility feeds).
• Familiarity with ACH/payment workflows
• Background in process improvement or system implementation.

Work Schedule & Remote Work

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.

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.