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, Cambia's dedicated The Membership Administrator I, are living our mission to make health care easier and lives better. As a member of the Customer & Member Services Operations team, our The Membership Administrator I 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 a person-focused health care experience.
Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
High school diploma or GED required
Minimum one year of accounts receivable or customer billing experience
Equivalent combination of education and job-related work experience will be considered
Skills and Attributes:
30 wpm with 95% accuracy typing skills
10-key by touch with 8500 keystrokes per hour at 95% accuracy preferred
PC experience with Word, Excel, and Outlook (or comparable software) and ability to learn and use complex systems
Strong math skills including mathematical calculations and concepts, with effective judgment and problem-solving abilities
Ability to organize and prioritize work while maintaining detail-oriented focus and self-motivation
Dependable attendance at or above departmental standards with ability to exercise judgment, initiative, and discretion in confidential and sensitive matters
Effective oral and written communication skills with ability to establish positive working relationships with staff and customers
What You Will Do at Cambia:
Process and manage enrollment applications for individuals and groups of all sizes, including calculating waiting-period credits, eligibility data, and effective dates; enter comprehensive member information (benefits, bank draft details, personal data, family members, PCP information with network coding) consistent with employer/individual contracts; review, maintain, and process account changes including coverage effective dates, member additions/deletions, and other modifications
Conduct proactive communication and verification by placing, receiving, and tracking calls to employers, agents, subscribers, and previous carriers to obtain required information for application processing, such as verifying hire dates, benefit selections, and prior coverage effective dates; provide exceptional customer service to internal and external customers through written correspondence and telephone inquiries, making necessary corrections and adjustments
Execute eligibility and reconciliation tasks accurately and timely for assigned business segments, adhering to established procedures; identify discrepancies between payments and invoiced amounts; generate and review group or individual billings for accuracy before distribution; ensure cash processing through daily reconciliation to meet established turnaround standards; monitor, pursue, and report on aged accounts to meet corporate standards
Manage member card operations and quality assurance by ordering member cards and auditing them against applications for accuracy, including verification of corporate logos, lines of business, co-pays, PCPs, and member card comments; ensure member confidentiality in all aspects of eligibility and billing processes
Apply and maintain compliance with corporate underwriting guidelines, governmental regulations, and policies in eligibility processing; for Government Programs roles, develop working knowledge of State and Federal regulations; incorporate and apply changes to Membership Accounting, Underwriting, or State and Federal policies to ensure current requirements are met; comply with MTM, Consortium, or Governmental quality and timeliness standards to meet BlueCross BlueShield Association or CMS standards
Coordinate data management and system operations by managing transfer and receipt of electronic data with external entities including CMS, employer groups, agents, and vendors; assist with user acceptance and system integration testing; identify and prioritize work to meet deadlines and established departmental performance expectations
Provide operational support and flexibility by working overtime and weekends as necessary; perform various clerical tasks; backup staff members through phone coverage, mail handling, filing, and special projects; attend and actively participate in training sessions and staff meetings
#LI – Remote
The expected hiring range for a The Membership Administrator I is $18.25 - $24.00 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full hourly range for this role is $18.25 - $27.20
The expected hiring range for a The Membership Administrator II is $18.25 - $26.00 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full hourly range for this role is $18.25 - $29.40
The expected hiring range for a The Membership Administrator III is $20.50 - $30.80 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 5%. The current full hourly range for this role is $19.20 - $34.90
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 we're 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:
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:
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 CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.
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