Membership Representative

Elevance Health

Membership Representative I at Elevance Health providing customer service for plan members and resolving enrollment issues. Engaging with clients through calls, ensuring accuracy in billing and account management.

Posted 7/14/2026full-timeIndianapolis • Florida, Kentucky, Ohio • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in customer service, enrollment processes, and billing management, ensuring accuracy and timeliness in handling member inquiries and account reconciliations. Proficient in maintaining enrollment databases and resolving discrepancies to support positive customer relations.

Highest-signal resume keywords

Customer ServiceEnrollment ManagementBilling ReconciliationData AccuracyIssue Resolution

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Enrollment VerificationBilling ProcessesError ResolutionPremium CollectionDatabase Maintenance

Soft Skills

CommunicationProblem-SolvingCustomer RelationsAttention to Detail

Industry Keywords

Membership ExperienceEligibility DeterminationContract LanguagePayment AdjustmentsAudit Processes

About the role

Key responsibilities & impact

Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
May be responsible for billing and delinquency processes for assigned groups.
Ensures accuracy and timeliness of the membership and billing function.
Responds to inquiries concerning enrollment processes.
Maintains enrollment database.
May order identification cards.
Determines eligibility and applies contract language for each case assigned.
Performs error output resolution for electronic eligibility and processes error discrepancy list.
Bills, collects premiums and reconciles payments.
Maintains and reconciles premium bill, self-bill and individual billed accounts.
Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.
Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits.
Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system.
Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
Thoroughly documents inquiry outcomes for accurate tracking and analysis.
Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

Requirements

What you’ll need

Requires a HS diploma or GED and related experience; or any combination of education and experience which would provide an equivalent background.
Membership experience or a strong customer service background strongly preferred.

Benefits

Comp & perks

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short and long-term disability benefits
401(k) + match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources