Job Description

Accounting & Billing Manager
San Antonio, TX.$90k-$110k Base Salary + Great Benefits

Overview
The Premium Accounting & Billing Manager will oversee the daily execution of our premium collection and billing workflows. You will lead a team of specialists, ensuring zero-balance accuracy in reconciliation's and maintaining seamless financial coordination between clients and insurance carriers. This is a high-impact leadership role with visibility across finance, operations, and client-facing teams.

This role in San Antonio with a TPA (Third Party Administrator). You’d be owning the full billing cycle—billing, collections, and reconciliation—while leading a small team.

It’s a great fit for someone who’s been deep in premium billing and reconciliation and wants more ownership without stepping away from the work. High visibility, stable environment, and real impact on operations.

Key Responsibilities

• Daily Operations: Supervise the end-to-end billing cycle, including invoice generation, premium collection, and timely remittance to carriers.
• Team Leadership: Manage daily activities for a small team of premium specialists, providing hands-on support and ensuring all deadlines are met.
• Financial Reconciliation: Directly perform and review complex reconciliation's of eligibility data against premium payments to ensure financial integrity.
• Carrier & Vendor Point of Contact: Serve as the primary liaison for insurance carriers regarding premium audits, delinquency resolution, and funding discrepancies.
• Compliance & Audit Support: Maintain meticulous records to ensure adherence to ERISA and HIPAA standards; prepare documentation for annual audits.
• Reporting: Develop and monitor daily/weekly reports on billing accuracy, aging reports, and collection cycle times for the management team.

Qualifications

• Experience: 3–5 years of hands-on experience in premium accounting, billing, or financial operations within the insurance or TPA industry.
• Software Skills: Strong proficiency in Sage or similar accounting software is required.
• Technical Knowledge: Solid understanding of self-funded health plans and multi-tier billing structures.
• Compliance: Basic understanding of regulatory requirements (ERISA, ACA) governing premium handling.
• Preferred: Familiarity with the Davis-Bacon Act or Service Contract Act (SCA) fringe benefit administration.
• Education: Bachelor’s degree in Accounting, Finance, or Business Administration.

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