Membership Specialist III

Premera; Washington; Hybrid; USD 55,000 - 83,000; Full time

Benefits offered by this job

Medical, vision, and dental coverage

401K employer match

Pension plan

Wellness programs and resources

Generous paid time off

Job summary

Premera is seeking a Membership Specialist III in Washington to ensure members access and use their health coverage confidently. You will resolve complex account discrepancies, apply regulatory requirements, and drive process improvements across lines of business.

The role requires 3+ years in customer service or related fields, an associates or bachelor's in accounting/finance, and healthcare/insurance industry experience. Hybrid on-campus work with Premera rewards and benefits is offered.

Qualifications

• Three (3) years of experience in customer service, accounting, finance, and/or billing.

Responsibilities

• Review plan provisions and apply specific rules inherent to the line of business.
• Apply contractual, state and federal guidelines (ACA, Senior Markets, MTM) ensuring compliance.
• Research, investigate and resolve complex account discrepancies and financial reconciliation.
• Identify improvement opportunities, recommend solutions, and mitigate issues.
• Develop and maintain requirements within Premera systems for the specific line of business.
• Participate in user acceptance testing and support rollout of new processes, features and tools.
• Effectively communicate plan requirements with internal/external partners or customers.
• Develop and maintain relationships with internal stakeholders cross functionally.
• Other responsibilities as assigned.

Skills

Customer service

Accounting/finance

Billing

Education

Associates or Bachelor's Degree in accounting/finance

Job description

Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People’s Lives

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/.

As a Membership Specialist III, you will help ensure members can access and use their health coverage with confidence. By completing accurate enrollment work, resolving complex account and reconciliation issues, and applying contractual and regulatory requirements, you will reduce disruptions and create a simpler, more reliable experience for the people we serve. Your analysis will also uncover root causes and drive process improvements that strengthen accuracy, efficiency, and service across multiple lines of business.

What you will do:

• Review plan provisions and apply specific rules inherent to the line of business.
• Apply contractual, state and federal guidelines as appropriate (i.e., Affordable Care Act, Senior Markets, and Member Touchpoint Measures/MTM), ensuring work is in compliance with federal and state regulations.
• Research, investigate and resolve complex account discrepancies and financial reconciliation between company systems and/or third party vendor systems.
• Identify improvement opportunities, recommend solutions, and mitigate issues throughout analysis.
• Develop and maintain requirements within Premera systems encompassing the specific line of business.
• Participate in user acceptance testing and support roll out of new processes, features and tools.
• Effectively communicate specific plan requirements with internal/external business partners and/or customers.
• Develop and maintain relationships with internal stakeholders cross functionally.
• Other responsibilities as assigned.

What you will bring:

• A combination of three (3) years of experience in customer service, accounting, finance, and/or billing (Required).
• An Associates or Bachelor's Degree in accounting/finance.
• Healthcare or insurance industry experience.
• Experience in Premera Customer Service or Membership & Billing.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they’re a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

• Medical, vision, and dental coverage with low employee premiums.
• Voluntary benefit offerings, including pet insurance for paw parents.
• Life and disability insurance.
• Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
• Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
• Generous paid time off to reenergize.
• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement. Commuter perks make your trip to work less impactful on the environment and your wallet. Free convenient on-site parking. Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable. Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.

Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling. Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at [e-mail] or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience. The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

• National Salary Range: $48,400.00 - $72,600.00
• National Plus Salary Range: $55,200.00 - $82,800.00 *National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions. At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy we change lives. As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.

Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.