Membership Eligibility Processor I

Cambia Health Solutions; Renton (WA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading health solutions provider is looking for a Membership Eligibility Processor I to work remotely from Oregon, Washington, or Idaho. In this role, you will manage subscription eligibility through processing applications and demographic changes. The ideal candidate should have a high school diploma, data entry experience, and excellent communication skills. Join a company that values health care innovation and offers generous benefits, including paid time off and a competitive salary range of $17.75 - $19.10/hour.

Benefits

Medical, dental, and vision coverage

Generous paid time off

Market-leading retirement plan

Qualifications

• Must be detail-oriented and self-motivated.
• Six months data entry experience required.
• Ability to communicate effectively is essential.

Responsibilities

• Process enrollment applications for individual, small, large, trust, and specialized groups.
• Conduct outreach and verification calls to obtain required information.
• Provide customer service to internal and external customers while maintaining confidentiality.

Skills

Data entry accuracy

Detail-oriented

PC experience

Effective communication

Education

High school diploma or GED

Tools

Word

Excel

Outlook

Job description

Membership Eligibility Processor I

Work from home within Oregon, Washington, or Idaho

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 team of Membership Eligibility Processors are living our mission to make health care easier and lives better. As a member of the Sales Support & Operations team, our Membership Eligibility Processor I establishes and maintains accurate subscriber and member level eligibility through processing of new applications, member additions and deletions, policy revisions, demographic changes, renewal changes and any other maintenance affecting eligibility – all in service of making our members’ health journeys easier.

Do you have a passion for serving others and learning new things? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

• High school diploma or GED

• 30 wpm keying

• 10-key by touch

• Six months data entry experience with demonstrated ability to meet or exceed accuracy and production standards.

• Must be detail-oriented and self-motivated

• Must be dependable and maintain attendance at or above departmental standards

• Must be able to exercise judgment, initiative and discretion in confidential, mature and sensitive manner

• Must be able to establish effective working relationships with staff and customers

• Ability to understand mathematical calculations and concepts

• Ability to organize and prioritize work

• PC experience required; experience with Word, Excel, Outlook, and similar software

• Ability to communicate effectively

• Medical Terminology preferred for WSHIP health questionnaire processors

What You Will Do at Cambia:

• Process enrollment applicationsfor individual, small, large, trust, and specialized groups, including calculating waiting periods, entering member data, benefits information, and network coding consistent with contracts

• Review and maintain account changesfor individual and group accounts, including effective date modifications, adding/removing subscribers and dependents, and generating billings and member cards

• Conduct outreach and verification callsto employers, members, agents, and previous carriers to obtain required information for application processing and ensure accurate enrollment data

• Meet performance standards and deadlinesincluding LOS requirements, state timeliness standards, departmental expectations, and BCBSA/Consortium standards while prioritizing workload effectively

• Apply policy updates and ensure compliancewith Membership Accounting, Underwriting, State/Federal policies, Corporate Code of Business Conduct, and privacy/security requirements

• Provide customer serviceto internal customers and handle inquiries from external customers including groups, agents, and subscribers while maintaining confidentiality and supporting quality improvement initiatives

• Perform administrative dutiesincluding clerical tasks, manual maintenance, training participation, staff meetings, and overtime/weekend work as necessary

The expected hiring range for a Membership Eligibility Processor I is $17.75 - $19.10/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 salary range for this role is $17.75 - $24.90/hour.

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:

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

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:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

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 [e-mail] . Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy .