Manager, Billing & Funding

Job Summary We are seeking a dynamic and detail-oriented Manager of Billing & Funding to lead our financial operations related to claims payment operations, client funding, client billing for administrative services, COBRA, and Flexible Spending Account benefits (FSA/Flex) benefits and financial reconciliation at CGS Health. In this pivotal role, you will oversee a team that processes payments to providers and network partners, manages client claims bank accounts, administers billing for a broad range of client -facing services, and serves as the primary financial liaison with clients, stop-loss carriers, and itnernal stakeholders. The Manager is expected to lead with operation rigor, foster a collaborative team culture, and deliver meaningful data and insights to company leadership. Responsibilities Oversee and direct the team responsible for processing claims payments to healthcare providers and to the network per contractual terms. Oversee the accurate and timely billing of clients for TPA administrative service fees, ensuring invoices reflect contracted rates, plan populations, and any applicable adjustments. Oversee Flexible Spending Account (FSA/Flex) billing and administration, including employee contribution tracking, employer funding coordination, and reimbursement processing in accordance with IRS regulations and plan documents. Participate in leadership team meetings and present updates on department performance, capacity, risks, and opportunities. Collaborate cross-functionally with claims adjudication, account management, IT, and compliance teams. Qualifications Bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, or a related field preferred. Advanced degree or professional certification (e.g., CPA, CEBS, HFMA Fellow) preferred. 5+ years of experience in healthcare billing, claims payment operations, TPA administration, or a closely related financial role. 3+ years of supervisory or management experience, with demonstrated ability to lead teams and drive results. Experience working with self-funded health plans, employer benefit plan administration, COBRA administration, and Flexible Spending Account (FSA/Flex) programs required. Experience with Anthem network billing or similar carrier network payment arrangements a plus. Skills & Competencies Strong command of claims payment workflows, reconciliation, and trust account management. Exceptional analytical and problem-solving skills with high attention to detail. Proficient in Microsoft Excel (pivot tables, VLOOKUP/XLOOKUP, data modeling); experience with Conduent HSP software required. Strong written and verbal communication skills; ability to translate complex financial data for non-technical audiences. Demonstrated ability to manage multiple priorities and meet deadlines in a fast-paced environment. High degree of integrity and professionalism when handling sensitive financial and protected health information (PHI).

Pay:

$55,282.42 - $66,576.68 per year

Benefits:

401(k) Dental insurance Health insurance Health savings account Paid sick time Paid time off Vision insurance

Work Location:

In person