Remote Membership Billing & Reconciliation Specialist II

Premera Blue Cross; Wisconsin; Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, vision, dental coverage

401K employer match

Tuition assistance

Paid time off

Job summary

Premera Blue Cross is seeking a Membership Specialist II to perform moderate to complex reconciliation analysis and enrollment billing tasks for individuals or groups. The role emphasizes problem-solving, data integrity, and customer guidance within a healthcare membership context.

The position requires attention to detail, strong communication, and the ability to work across tools like Excel and Access while ensuring compliance with regulations.

Qualifications

• Moderate to complex reconciliation analysis and audit activities for accounts receivable.
• Resolve enrollment, reconciliation and billing issues.
• Coach internal/external customers on contractual guidelines.
• Proficiency with Access or Excel for eligibility, enrollment and reconciliation updates.
• Ensure compliance with federal and state regulations.

Responsibilities

• Identify, resolve and document complex reconciliation discrepancies independently.
• Process refunds, transfers of premiums, reinstatements, and insufficient fund issues.
• Maintain accurate notes and update enrollment changes as needed.
• Educate members, brokers, or groups on membership and billing processes, portal usage and contract interpretation.
• Respond to member/broker inquiries and resolve enrollment system rejections.

Skills

Analytical skills

Attention to detail

Education

High School diploma or GED

Associate's degree in accounting/finance

Associate’s or Bachelor's degree in accounting/finance

Tools

Excel

Access

Reconciliation tools

Job description

Premera Blue Cross is seeking a Membership Specialist II to perform moderate to complex reconciliation analysis and enrollment billing tasks for individuals or groups. The role emphasizes problem-solving, data integrity, and customer guidance within a healthcare membership context.

The position requires attention to detail, strong communication, and the ability to work across tools like Excel and Access while ensuring compliance with regulations.