Membership Enrollment & Billing Specialist

Insperity; Portland, Northern (OR, KY); Hybrid; USD 25,000 - 28,000; Full time

Benefits offered by this job

Medical, Dental, Vision & Pharmacy

PTO and Company Paid Holidays

401k - Matching

Job summary

Moda Health in Portland, OR is seeking an on-site Data Entry Specialist to support eligibility, enrollment and ID-card administration for Moda Health and BHS lines of business, including COBRA and TPA accounts.

The role includes accurate data entry, customer service to groups and members, and monthly reconciliation of premiums and fees. Strong Excel/Word skills and confidentiality are essential. This is a full-time on-site position with potential for occasional extended hours.

Qualifications

• High school diploma or equivalent.
• Previous experience and/or knowledge of Facets preferred.
• A minimum of 3 years’ experience preferred in fast paced business, data entry, customer service, enrollment, billing, and reconciliation environment.
• Computer proficiency with Microsoft Office applications particularly Excel and Word.
• Ten key proficiency of 135 kpm on a computer numeric keypad/calculator preferred.
• Typing proficiency of 25 wpm preferred.
• Strong analytical, problem solving, decision making, organizational and detail-oriented skills.
• Strong verbal, written and interpersonal communication skills.
• Ability to be courteous, patient and communicate with Moda Health and BHS members, Moda Health and BHS employees and Employer Groups in a positive and productive manner.
• Maintain confidentiality and project a professional business image.

Responsibilities

• Responsible for eligibility and enrollment procedures daily via paper enrollment, electronic file, web-based transactions, email enrollments, and sending welcome packet to our new members for all Moda and BHS products and lines of business.
• Ensure the accuracy and timeliness of entering enrollments within the department, Employer Groups, State and Federal standards depending on Product and Line of Business.
• Responsible for following delinquency policy and procedures to ensure both compliance and timely receipt of administrative fees and premiums.
• Ensures all member, premium and administrative fees are reconciled monthly to the penny.
• Maintains confidentiality of all information related to members, employer groups, employees, and as appropriate, other information.
• Highly motivated and able to take initiative, demonstrated ability to identify and solve problems.
• Responds to all internal and external customer inquiries regarding enrollments, ID cards and attends customer meetings as requested by Sales and Account Services.
• Responsible to log and track enrollment applications in excel and give monthly reports to the Supervisor and the groups that shows a running balance on total enrollments received; enrollments entered into our system; voids and pending.
• Accurately enter COB, COBRA and Pre-Existing for timely and accurate claims adjudication as well as sending out required COBRA notifications.
• Requests and verifies the issuance and accuracy of member ID cards.
• Keeping track of supplies and ordering when necessary.
• Process Return Mail.
• Adhere to and enforces group contract, State and Federal guidelines regarding eligibility standards and requirements.
• Be a supportive and collaborative teammate.
• Performs other duties and projects as assigned.

Skills

Data entry

Customer service

Enrollment

Billing

Reconciliation

Typing 25 wpm

Ten key 135 kpm

Analytical skills

Communication skills

Confidentiality

Education

High school diploma or equivalent

Tools

Facets

Excel

Word

Job description

Moda Health in Portland, OR is seeking an on-site Data Entry Specialist to support eligibility, enrollment and ID-card administration for Moda Health and BHS lines of business, including COBRA and TPA accounts.

The role includes accurate data entry, customer service to groups and members, and monthly reconciliation of premiums and fees. Strong Excel/Word skills and confidentiality are essential. This is a full-time on-site position with potential for occasional extended hours.