Enrollment and Billing Lead Representative (Premium Healthcare)
Experience: Job Code: REQ-033212
Sagility
Quezon City
job Details
Job title
Enrollment and Billing Lead Representative (Premium Healthcare)
About Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
This role is responsible for premium billing and collection, financial reconciliation, issue resolution, risk identification, and client support. The specialist partners with clients and internal teams to deliver a positive experience while protecting the organizationâs financial and operational interests.
Success requires strong analytical skills, independent judgment, ownership, and the confidence to professionally challenge requests that fall outside standard processes or create financial, compliance, or operational risk.
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Job Description:
DUTIES & RESPONSIBILITIES:
- Manage billing relationships for medical, dental, vision, and other applicable invoices.
- Support premium billing, payment reconciliation, allocation, collection, and issue resolution.
- Research discrepancies involving payments, rates, eligibility, commissions, and other billing concerns.
- Communicate with delinquent clients according to established collection processes.
- Analyze financial and operational data to identify trends, root causes, financial exposure, and operational risks.
- Evaluate non-standard requests and identify potential downstream impacts before decisions are finalized.
- Recommend sustainable alternatives when requests cannot be supported through standard procedures.
- Lead client, broker, and Third-Party Administrator calls (video) to explain billing processes and resolve concerns.
- Manage escalations and sensitive client situations with professionalism and urgency.
- Partner with Sales, Implementation, Underwriting, Finance, Operations, Client Management, Commissions, and other teams.
- Support new and renewing client implementations by reviewing billing requirements and identifying risks.
- Identify process gaps and recommend workflow improvements that increase accuracy, reduce manual work, and improve the client experience.
- Maintain accurate process documentation, client instructions, reporting, and issue tracking.
- Take ownership of problems through resolution and follow up on outstanding actions.
- Recommend monthly reserves or accruals to Finance when financial exposure is identified.
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