Membership Admin Account Specialist-1

BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); On-site; USD 38,000 - 48,000; Full time

Job summary

BlueCross BlueShield of Tennessee, Inc. is seeking a Membership Account Specialist to support Medicare enrollment, eligibility maintenance, and issue resolution. The role emphasizes accurate processing, CMS compliance, and collaboration with partners to enhance member experience.

The position is remote, Monday–Friday with standard business hours. Ideal candidates have strong analytical and organizational skills, a healthcare background, and proficiency in Microsoft Office to manage membership

Qualifications

• Education: High School Diploma or equivalent.
• Experience: 1 year in healthcare required.
• Skills/Certifications: Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint); Proficient oral and written communication skills; Proficient interpersonal and organizational skills.

Responsibilities

• Implement filing and documentation procedures; maintain all files in current condition.
• Communicate with underwriters, agents, loss control specialists or others to pass on policy and case information; use information to improve services and prevent problems.
• Meet assigned quality and workload expectations; implement revisions or improvements to procedures as necessary.
• Ensure all production, timeliness, and quality standards are met.
• Process assigned policies and cases according to department procedures; respond to complaints and inquiries, identifying and resolving difficulties in membership and benefits services.

Skills

Oral communication

Written communication

Interpersonal skills

Organizational skills

Education

High School Diploma or equivalent

Tools

Microsoft Office

Outlook

Word

Excel

PowerPoint

Job description

We are hiring a Membership Account Specialist at BCBST! In this role, you will play a critical part in supporting our Medicare membership by ensuring accurate and timely enrollment processing, eligibility maintenance, and issue resolution. You will research and resolve complex membership and enrollment discrepancies, process Medicare transactions in compliance with CMS regulations, and collaborate with internal and external partners to ensure a seamless member experience. The Membership Account Specialist serves as a subject matter expert for Medicare enrollment and billing processes, supports operational initiatives, analyzes account-related issues, and helps maintain the accuracy and integrity of membership data. To be successful in this role, you will bring strong analytical, problem-solving, and organizational skills, along with a thorough understanding of Medicare enrollment regulations and membership operations. Ideal candidates are detail-oriented, customer-focused, able to navigate complex scenarios, and committed to delivering accurate, compliant, and high-quality service while supporting operational excellence and positive outcomes for our Medicare members. We foster a culture where innovation is encouraged, supporting employees with the tools and resources needed to succeed while promoting growth, creativity, and continuous learning.

Note

This is a remote, Monday-Friday position working standard business hours. Candidates should be comfortable working independently while maintaining strong collaboration with cross-functional teams.

Job Responsibilities

• Implementing appropriate filing and documentation procedures; maintaining all physical and electronic files in current and accurate condition.
• Communicating with underwriters, agents, loss control specialists or any others to both receive and pass on all relevant policy and case information; utilizing information to improve services, anticipate and prevent problems, or suggest improvements.
• Meeting assigned quality and work load expectations; implementing revisions or improvements to procedures, as necessary.
• Ensure all production, timeliness, and quality standards are met.
• Processing assigned policies and cases according to department procedures and expectations; responding to complaints and inquiries, identifying and resolving difficulties in membership and benefits services.

Job Qualifications

• Education: High School Diploma or equivalent
• Experience: 1 year - Experience in the healthcare industry required
• Skills/Certifications: Proficient in Microsoft Office (Outlook, Word, Excel and Powerpoint) Proficient oral and written communication skills Proficient interpersonal and organizational skills

Position Details

Number of Openings Available 1 Worker Type: Employee Company: BCBST BlueCross BlueShield of Tennessee, Inc.

EEO Statement

Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow. At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability. We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST. We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members. BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based. BCBST hires employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense. If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance.