Cambia Health Solutions

Membership Administrator I - III, DOE

Cambia Health Solutions

full-time

Posted on:

Origin:  • 🇺🇸 United States

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Salary

💰 $18 - $34 per hour

Job Level

Junior

About the role

  • Process enrollment applications for individuals and groups, calculating eligibility data, effective dates, and entering member information consistent with contracts.
  • Review and maintain account changes including effective dates, additions/deletions of members, and verify information through calls to employers, subscribers, or carriers as needed.
  • Provide customer service through written correspondence and phone inquiries, making necessary corrections while ensuring member confidentiality.
  • Perform eligibility and reconciliation tasks accurately and timely, including generating and reviewing billings, processing cash, and monitoring aged accounts to meet corporate standards.
  • Order and audit member cards for accuracy, including corporate logos, lines of business co-pay, PCP, and member card comments.
  • Apply corporate underwriting guidelines, governmental regulations, and updated policies to ensure compliance with federal, state, BCBSA and accreditation requirements.
  • Coordinate electronic data transfer with external entities including CMS, employer groups, agents, and vendors; assist with system testing as needed.
  • Support team operations by providing phone coverage, assisting with clerical tasks, participating in training, and working overtime when required.

Requirements

  • High School diploma or GED and one-year accounts receivable or customer billing experience or an equivalent combination of education and job-related work experience.
  • The Membership Administrator II would have a High School diploma or GED and one year experience as Membership Administrator I performing all duties at the Core or higher performance level or an equivalent combination of education and job-related work experience.
  • The Membership Administrator III would have a High School diploma or GED and 18 months as a Membership Administrator II performing at the Core or higher performance level or an equivalent combination of education and job-related work experience.
  • 30 wpm with 95% accuracy typing skills.
  • 10-key by touch (8500 keystrokes per hour with 95% accuracy preferred).
  • PC experience – Word, Excel and Outlook – or comparable software – and ability to learn and use complex systems.
  • Strong math skills (mathematical calculations and concepts), judgment and other resources to implement effective problem solving.
  • Ability to coordinate and prioritize work.
  • Must be diligent and self-motivated.
  • Must be conscientious and maintain attendance at or above departmental standards.
  • Ability to exercise judgment, initiative and discretion in confidential, mature and sensitive manner.
  • Ability to communicate effectively both orally and in writing.
  • Ability to establish effective working relationships with staff and customers