Membership Administrator I, II, or III DOE
Membership Administrator I, II, or III DOE
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Job Description
Membership Administrator I II or III DOE
Work from home within Oregon Washington Idaho or Utah
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day Cambias dedicated team of Membership Administrators are living our mission to make health care easier and lives better. As a member of the Customer and Member Services Operations team our Membership Administrator establishes and maintains eligibility bills premium reconciles cash pursues aged accounts and provides eligibility and billing related customer service for Individual Group Government Programs Cobra and Flexible Spending business all in service of creating an economically sustainable health care system.
Do you thrive as a part of a collaborative caring team Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
The Membership Administrator I would have a 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 asMembership 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.
Skills and Attributes:
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 organize and prioritize work.
Must be detail-oriented and self-motivated.
Must be dependable and maintain attendance at or above departmental standards.
Must be able to exercise judgment initiative and discretion in confidential mature and sensitive manner.
Must be able to communicate effectively both orally and in writing.
Must be able to establish effective working relationships with staff and customers
What You Will Do at Cambia:
Process enrollment applicationsfor individuals and groups including calculating waiting periods entering member data benefits information and ensuring compliance with employer/individual contracts
Maintain and update member accountsby processing changes such as effective dates adding/removing members from coverage and making necessary corrections or adjustments
Conduct outreach communicationsto employers agents subscribers and previous carriers to verify information needed for complete application processing
Provide comprehensive customer serviceto internal and external customers through written correspondence and telephone support resolving inquiries and issues
Perform eligibility verification and reconciliationtasks accurately and timely identifying payment discrepancies and ensuring proper billing processes
Generate and review billing statementsfor accuracy before distribution and order/audit member cards against applications for correct information and corporate branding
Apply underwriting guidelines and regulatory complianceincluding corporate policies and state/federal regulations particularly for government programs
Manage cash processing and aged accountsthrough daily reconciliation to meet corporate turnaround standards and reporting requirements
Coordinate data transfers and system testingwith external entities (CMS employers agents vendors) while ensuring compliance with quality and timeliness standards
Support departmental operationsthrough backup coverage clerical tasks training participation overtime work as needed and maintaining member confidentiality throughout all processes
Additional General Functions and Outcomes for levels II and III:
Execute advanced eligibility and reconciliation tasksincluding detailed research problem-solving auditing complex issues and ensuring accurate financial reporting for all account types including self-funded accounts
Provide leadership and training supportby coaching and mentoring staff at all levels conducting professional presentations for employer groups and agents and serving as a role model for ethical work practices
Maintain regulatory compliance and documentationby keeping current with state and federal regulations (especially for government programs) updating policy manuals and responding to state insurance commission inquiries
Support system development and quality initiativesthrough creating test cases assisting with user acceptance testing participating in process improvement teams and completing RFPs for account optimization
Represent the division professionallyby attending and facilitating internal/external meetings assisting supervisors and leads as needed and coordinating cross-functional activities to meet corporate standards
The Membership Administrator I would have a 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 asMembership 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.
About Cambia
Working at Cambia means being part of a purpose-driven award-winning culture built on trust and innovation anchored in our 100 year history. Our caring and supportive colleagues are some of the best and brightest in the industry innovating together toward sustainable person-focused health care. Whether were helping members lending a hand to a colleague or volunteering in our communities our compassion empathy and team spirit always shine through.
Why Join the Cambia Team
At Cambia you can:
- Work alongside diverse teams building cutting-edge solutions to transform health care.
- Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
- Grow your career with a company committed to helping you succeed.
- Give back to your community by participating in Cambia-supported outreach programs.
- Connect with colleagues who share similar interests and backgrounds through our employee resource groups.
We believe a career at Cambia is more than just a paycheck and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match bonus opportunities and more.
In exchange for helping members live healthy lives we offer benefits that empower you to do the same. Just a few highlights include:
- Medical dental and vision coverage for employees and their eligible family members including mental health benefits.
- Annual employer contribution to a health savings account.
- Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
- Market-leading retirement plan including a company match on employee 401(k) contributions with a potential discretionary contribution based on company performance (no vesting period).
- Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
- Award-winning wellness programs that reward you for participation.
- Employee Assistance Fund for those in need.
- Commute and parking benefits.
Learn more about our benefits.
We are happy to offer work from home options for most of our roles. To take advantage of this flexible option we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.
We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race color national origin religion age sex sexual orientation gender identity disability protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability please email . Information about how Cambia Health Solutions collects uses and discloses information is available in our .
Required Experience:
Unclear Seniority
Employment Type
Full-Time
