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At MVP Health Care, we’re on a mission to create a healthier future for everyone – which requires innovative thinking and continuous improvement. To achieve this, we’re looking for a Professional, Member Ops Billing Specialist to join #TeamMVP. If you have a passion for driving efficiency in healthcare operations and analytical thinking this is the opportunity for you.

What’s in it for you:

+ Growth opportunities to uplevel your career

+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team

+ Competitive compensation and comprehensive benefits focused on well-being

+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work** for and one of the **Best Companies to Work For in New York**

Qualifications you’ll bring:

+ A Bachelor’s degree or equivalent combination of education and related experience

+ The availability to work full-time, hybrid

+ 3-5 years of experience in healthcare operations, billing, financial, or customer service role required

+ Ability to serve as a key stakeholder in cross-functional projects and communicate with technical teams

+ Strong analytical and problem-solving skills required

+ Interest or familiarity with AI concepts and automation tools preferred

+ Curiosity to foster innovation and pave the way for growth

+ Humility to play as a team

+ Commitment to being the difference for our customers in every interaction

Your key responsibilities:

+ Lead audits such as DOH, SOC, and Model Audit Rule (MAR)

+ Analyze and interpret data from Commercial, On/Off-Exchange, and Medicare reports

+ Participate in and play a lead role in project meetings and initiatives

+ Develop and manage testing plans for system enhancements and invoice validation

+ Train and support team members on new processes and tools

+ Collaborate with Digital Transformation & Technology to define automation requirements and workflows

+ Evaluate and implement AI tools for tasks such as reconciliations, refunds, and data validation

+ Monitor and manage AI-driven processes and escalate issues as needed

+ Document automation use cases, outcomes, and continuous improvement opportunities

+ Other duties as assigned by leadership

+ Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Where you’ll be:

Hybrid- Schenectady or Rochester

Pay Transparency

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

We do not request current or historical salary information from candidates.

MVP's Inclusion Statement

At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.

MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.

To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at [email protected] .

Job Details

Job Family** **Claims/Operations

Pay Type** **Salary

Hiring Min Rate** **52,423 USD

Hiring Max Rate** **75,000 USD