Work in Washington Veterans Jobs

Job Information

Cambia Health Solutions Membership Administrator I, II, or III DOE in Tacoma, Washington

Membership Administrator I, II, or III DOE Remote within WA, ID, OR, and UT Primary Job Purpose: The 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. Additionally, the Membership Administrator applies many of the procedures and services performed as a Membership Administrator I to complex and specialized accounts, requiring more in-depth knowledge. Normally to be proficient in the competencies listed below: 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. Responsibilities: * Perform accurately and timely all eligibility and reconciliation tasks and adhere to established procedures for working large, complex or specialized accounts. * Assist less experienced staff with questions and/or difficult issues or accounts as needed. * Assist Membership Administrator III and Member Services Lead as appropriate. * Conduct professional presentations and training for a variety of customers including employer groups and agents. * Process Individual, and/or, small, large or specialized group enrollment applications. Calculate appropriate waiting-period credit, eligibility data, effective date, and enter benefits, bank draft identification information, name, social security number, address, family members and primary care physician information with network coding, which is consistent with the employer/individual contract. * Review, maintain and enter changes on individual and/or group accounts which may include change of effective date(s) for insured coverage or members, addition or deletion of insured or members from coverage, etc. Sources for this information are applications, invoices, reports or web based data. * Place, receive and track calls to obtain information required to complete application processing such as calling an employer or agent to verify date of hire, a subscriber to verify benefit selection, or the previous carrier to determine effective dates of coverage with their plan. * Provide customer service to internal and external customers, including Regulatory inquiries by supplying information through written correspondence and responding to telephone inquiries. Make any necessary corrections or adjustments. * Perform all eligibility and reconciliation tasks accurately and timely for assigned business segment, adhering to established procedures including identification of discrepancies between payment and amount invoiced. * Generate group or individual billings. Review billings and ensure accuracy before distributing. * Order member cards and audit these against the member applications for accuracy correct corporate logos, lines of business co-pay, PCP, and any member card comments. * Appropriately apply corporate underwriting and governmental guidelines and policies in eligibility processing. * Ensure cash is processed through daily reconciliation to achieve established cash turnaround standards. * Identify and prioritize work in order to meet deadlines. * Maintain manuals to ensure policies and procedures are current. * Monitor, pursue and report on aged accounts to ensure amounts are accurate and cleared in time to meet goal of achieving corporate standards. * For Government Programs related jobs, maintain updated knowledge of State and Federal regulations. * Incorporate and apply changes made to Membership Accounting, Underwriting or State and Federal policies and procedures to ensure current requiremen To view the full job description, click here{rel="nofollow"}