Membership Admin Account Specialist-1

BlueCross BlueShield of Tennessee; United States; Remote; USD 42,000 - 64,000; Full time

Job summary

BlueCross BlueShield of Tennessee is seeking a remote Membership Account Specialist to support Medicare enrollment processing, eligibility maintenance, and issue resolution with accuracy and timeliness. You will collaborate with underwriters, agents, and cross-functional teams to ensure compliant, high-quality service and to resolve complex membership discrepancies.

Ideal candidates are detail-oriented, analytical, and customer-focused, with strong organizational skills and knowledge of Medicare

Qualifications

• High School Diploma or equivalent required.
• 1 year experience in the healthcare industry required.
• Proficient in Microsoft Office and strong communication skills.

Responsibilities

• Implement filing and documentation procedures; maintain all files current and accurate.
• Communicate with underwriters, agents, and loss control specialists to exchange policy and case information and drive service improvements.
• Meet quality, workload, timeliness, and production standards; apply revisions to procedures as needed.
• Process policies and cases per department procedures; respond to inquiries and resolve membership and benefits issues.

Skills

Communication

Interpersonal skills

Organizational skills

Education

High School Diploma or equivalent

Tools

Microsoft Office Suite

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

Number of Openings Available

1

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

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.