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Premium Billing Analyst Jobs (NOW HIRING)

Novacore

Premium Billing Analyst (Managed Care)

Plymouth, MN · On-site

$50K - $67K/yr

Premium Billing Analyst (Managed Care) The Managed Care Premium Analyst plays a pivotal role in the administration and management of premium billing functions within the Managed Care program at ...

Novacore

Premium Billing Analyst (Managed Care)

Plymouth, MN · On-site

$50K - $67K/yr

Premium Billing Analyst (Managed Care) The Managed Care Premium Analyst plays a pivotal role in the administration and management of premium billing functions within the Managed Care program at ...

UHA

Premium Billing Representative II

Honolulu, HI · On-site

$17.50 - $23/hr

Premium Billing Rep II Position Summary The Premium Billing Rep II is responsible for performing ... Research, analyze, and resolve billing discrepancies, including reconciliation of billing ...

GIS National LLC

Billing Analyst

Saint Petersburg, FL · On-site

$45K - $61K/yr

Analyze billing data and prepare it for processing, validate billing premiums by manually calculating rates * Create basic reports for invoice reconciliation, auditing, and data requests * Populate ...

Medix

Premium Billing Specialist

Virginia Beach, VA · On-site

$23 - $25/hr

Job Summary Our client is seeking a Biller responsible for conducting higher-level analytical work. This role involves account reconciliations, managing complex financial transactions, and resolving ...

Allied

Billing Coordinator

Chicago, IL · On-site +1

$20 - $23/hr

Execute monthly premium billing processes in QicLink system, including importing and validating ... Identify and analyze recurring issues, perform root cause analysis, and recommend corrective ...

Allied Benefit Systems

Billing Coordinator

Chicago, IL · Remote

$20 - $23/hr

Execute monthly premium billing processes in QicLink system, including importing and validating ... Identify and analyze recurring issues, perform root cause analysis, and recommend corrective ...

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Premium Billing Analyst information

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$32.5K

$60.3K

$121K

How much do premium billing analyst jobs pay per year?

As of Aug 28, 2026, the average yearly pay for premium billing analyst in the United States is $60,263.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $64,000.00 per year, depending on experience, location, and employer.

What does a premium billing analyst do?

A Premium Billing Analyst is responsible for managing and reconciling premium payments for insurance policies. They ensure that invoices are accurate, payments are processed correctly, and account discrepancies are resolved promptly. Their work involves communicating with clients, insurance carriers, and internal departments to handle billing inquiries or issues. This role requires strong analytical skills, attention to detail, and a good understanding of billing procedures and insurance products.

What are the key skills and qualifications needed to thrive as a premium billing analyst?

To thrive as a Premium Billing Analyst, you need strong analytical abilities, attention to detail, and a background in finance or accounting, often supported by a relevant degree or equivalent experience. Familiarity with billing software, enterprise resource planning (ERP) systems, and proficiency in Microsoft Excel are typically required, and some roles may prefer certification in billing or accounting. Excellent problem-solving, communication, and organizational skills set standout analysts apart when managing complex billing inquiries and collaborating with clients and internal teams. These skills are crucial for ensuring accurate premium processing, minimizing errors, and maintaining strong client relationships in a highly regulated industry.

How does a premium billing analyst typically collaborate with other departments to resolve billing discrepancies?

As a Premium Billing Analyst, you will regularly work with teams such as customer service, underwriting, and finance to investigate and resolve billing discrepancies. Effective communication and attention to detail are essential, as you may need to clarify policy details, validate premium amounts, or coordinate corrections to invoices. This cross-functional collaboration helps ensure customers are billed accurately and issues are resolved promptly, contributing to a smooth billing process and positive client experience.

What is the difference between Premium Billing Analyst vs Billing Specialist?

AspectPremium Billing AnalystBilling Specialist
CredentialsTypically requires a bachelor's degree in finance, accounting, or related field; certifications like CPA or CPC are commonOften requires a high school diploma or associate degree; certifications are less common
Work EnvironmentUsually in finance or insurance companies, handling complex billing processesWorks in various industries, managing routine billing tasks
Employer & Industry UsagePrimarily in insurance, healthcare, and financial servicesWidespread across multiple industries including retail, healthcare, and insurance

The Premium Billing Analyst focuses on complex billing processes, often requiring specialized knowledge and certifications, mainly within insurance and finance sectors. In contrast, Billing Specialists handle routine billing tasks across various industries, typically with less emphasis on advanced credentials. Both roles are essential for accurate revenue management but differ in complexity and scope.

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What job categories do people searching Premium Billing Analyst jobs look for?

The top searched job categories for Premium Billing Analyst jobs are:

Premium Billing Analyst jobs near you
Infographic showing various Premium Billing Analyst job openings in the United States as of August 2026, with employment types broken down into 67% Full Time, 19% Part Time, 1% Temporary, 12% Contract, and 1% Nights. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $60,263 per year, or $29 per hour.

Premium Billing Analyst (Managed Care)

Plymouth, MN • On-site

Novacore
See more jobs at Novacoreexternal

$50K - $67K/yr

Full-time

Medical

Posted 15 days ago

Job description

Why join the Novacore team?
Because your next stellar chapter starts here - and we're building something bold and meaningful.
At Novacore, we're not your average insurance company. We're a team of driven professionals passionate about redefining the specialty insurance experience for our agents, carrier partners - and for each other.
We specialize in tailored solutions for niche industries, powered by advanced analytics, modern technology and a culture of innovation. Backed by strong leadership and strategic growth initiatives, Novacore is poised to scale and lead in the specialty insurance market.
But at our core, we believe it's not just what we do - it's how we do it and who we do it with.
Recognized as a top workplace, Novacore is a place where ambition is supported, growth is continuous and culture matters. From day one, you'll find mentorship, hands-on learning and clear paths for advancement. You'll grow your skills, expand your expertise and become even more exceptional - because when you succeed, we all do.
We offer:
  • A collaborative, results-driven environment
  • Competitive compensation and comprehensive benefits
  • Year-round social and community events
  • Ongoing mentorship and professional development
  • Endless opportunities for upward mobility

So if you're ready to be part of something extraordinary - with a team that's transforming commercial insurance - we want to meet you.
Premium Billing Analyst (Managed Care)
The Managed Care Premium Analyst plays a pivotal role in the administration and management of premium billing functions within the Managed Care program at Carbon Stop Loss Solutions.
This position is responsible for ensuring accurate and timely billing for managed care products including HMO, PPO, EPO, and self-funded health plan arrangements, resolving complex billing issues, collaborating with underwriting, claims, network management, and accounting teams, and providing exceptional service to clients and carrier partners. The ideal candidate will have a strong background in managed care premium billing and health plan administration, excellent analytical skills, and the ability to manage multiple priorities while working independently.
Responsibilities:
Premium Billing Management:
  • Oversee and process monthly premium billings for managed care products (HMO, PPO, EPO, CDHP) and self-funded health plan arrangements, ensuring accuracy and timeliness.
  • Review and analyze complex premium data, including composite and age-banded rating structures, adjusting for enrollment changes, plan design amendments, carrier rate changes, and mid-year renewals.
  • Administer premium remittance to carrier partners and reinsurers, ensuring proper allocation across multiple funding arrangements (fully insured, level-funded, and self-funded).
  • Collaborate with internal teams and outsourced partners to ensure premiums are billed accurately based on current enrollment data, benefit plan details, and carrier contract terms.

Enrollment & Eligibility Administration:
  • Process and validate member enrollment and eligibility data received from employer groups, ensuring accurate subscriber and dependent counts are reflected in monthly billings.
  • Manage retroactive enrollment adjustments and retroactive terminations, calculating and applying premium credits or back-billings as appropriate.
  • Coordinate with carrier partners to confirm eligibility file transmissions and resolve discrepancies between internal records and carrier enrollment rosters.

Client Communication & Support:
  • Serve as the primary point of contact for employer groups and brokers regarding premium billing inquiries, enrollment discrepancies, and payment issues specific to managed care products.
  • Provide clear, timely, and professional communication regarding billing statements, premium adjustments, payment schedules, and grace period policies in accordance with managed care contract terms.
  • Assist clients in understanding billing statements, rate structures, dependent tier categories, and payment schedules across multiple managed care plans offered under their group contracts.

Reconciliation & Reporting:
  • Perform reconciliation of premium payments against carrier invoices and internal billing records, including matching payments, identifying discrepancies across multiple plan options, and resolving outstanding balances.
  • Prepare management reports highlighting billing trends, enrollment fluctuations, payment status, loss ratio indicators, and any potential issues affecting the managed care book of business.
  • Issue and manage delinquency notices in accordance with carrier contract requirements and applicable state continuation of coverage (COBRA/state continuation) regulations.
  • Track and report on experience refunds, dividend calculations, and carrier settlement reconciliations applicable to experience-rated managed care programs.

Process Improvement & Compliance:
  • Recommend and implement process improvements to enhance billing accuracy, enrollment data integrity, and client satisfaction across the managed care program portfolio.
  • Ensure compliance with all applicable regulatory requirements including ACA mandates, ERISA, HIPAA privacy standards, and state insurance department regulations governing premium billing and group health coverage.
  • Assist in internal and external audits, ensuring that all billing records, enrollment files, and carrier remittance documentation are accurately maintained and readily available for review.

Carrier & Network Partner Relations:
  • Maintain strong working relationships with carrier billing contacts to facilitate timely resolution of premium discrepancies, enrollment file errors, and remittance reconciliation issues.
  • Liaise with underwriting, network management, and claims teams to ensure premium rates accurately reflect negotiated network access fees, stop loss attachment points, and any applicable medical management program charges.

Collaboration:
  • Work closely with underwriting, claims, network management, and policy issuance teams to ensure premiums are billed correctly and reflect current plan designs, negotiated rates, and carrier contract terms.
  • Assist in the training and mentorship of junior billing staff, providing guidance on complex managed care billing scenarios including multi-carrier arrangements and tiered network products.

Problem Solving & Issue Resolution:
  • Investigate and resolve billing discrepancies and client disputes related to premiums, enrollment counts, rate tier classifications, or carrier remittance errors across managed care products.
  • Escalate complex issues to management as needed while proposing effective solutions, particularly for situations involving carrier coverage disputes, retroactive rate changes, or lapse and reinstatement scenarios.

Qualifications:
  • Bachelor's degree in Business Administration, Finance, Accounting, Healthcare Administration, or a related field preferred.
  • Minimum of 5+ years of experience in premium billing within the health insurance or managed care industry.
  • Demonstrated experience with managed care products including HMO, PPO, EPO, and CDHP plans; experience with self-funded and level-funded arrangements strongly preferred.
  • Experience working with an MGU, TPA, health plan carrier, or employee benefits brokerage/consulting firm preferred.
  • Strong experience with billing systems, benefits administration platforms, and accounting software. Experience with ESL Office, BenAdmin, or similar group health billing systems preferred.
  • Strong attention to detail and accuracy in high-volume, multi-plan billing environments.
  • Familiarity with managed care concepts including network tiering, utilization management, care coordination, medical management programs, and their impact on premium structures.
  • Knowledge of ACA compliance requirements, ERISA, HIPAA, COBRA, and state-specific group health insurance regulations.
  • Excellent organizational and time management skills with the ability to manage multiple group accounts, billing cycles, and carrier relationships simultaneously.
  • Strong communication skills, both written and verbal, with the ability to explain complex billing and managed care concepts to employer groups, brokers, and internal stakeholders.
  • Proficient in Microsoft Office Suite, particularly Excel (including pivot tables and VLOOKUP for enrollment and billing reconciliation); experience with data imports/exports between billing and enrollment systems preferred.
  • Ability to work under pressure and meet tight billing deadlines while maintaining accuracy across a multi-carrier, multi-product managed care book of business.

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