Membership Admin Account Specialist-1

bcbst; United States; Remote; USD 48,000 - 68,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. is seeking a Membership Account Specialist to support Medicare membership by ensuring accurate enrollment processing, eligibility maintenance, and issue resolution.

This remote role requires strong analytical and communication skills, attention to detail, and knowledge of Medicare enrollment rules. You will collaborate with cross-functional teams to deliver high-quality service to members and uphold CMS compliance.

Qualifications

• Experience in the healthcare industry is preferred.
• 1 year minimum experience in a related role.

Responsibilities

• Maintain accurate filing and documentation of policies and cases.
• Communicate with underwriters, agents, and other stakeholders to obtain and share policy information.
• Meet quality and workload standards while adhering to procedures.

Skills

Oral and written communication

Interpersonal skills

Organizational skills

Education

High School Diploma or equivalent

Tools

Microsoft Office

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.

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.

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.