Remote Membership Billing Specialist II

Premera Blue Cross; Accident (AR); Remote; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical coverage

Vision coverage

Dental coverage

401K match

Pension plan

Job summary

Premera Blue Cross is seeking a Membership Specialist II to perform moderate to complex reconciliation analysis and audit activities for Individual or Group accounts receivable. This role supports enrollment, billing, and premium reconciliations, working within specified hours across Pacific/Mountain/Central time zones.

The position requires strong numerical accuracy, knowledge of Access/Excel, and the ability to coach customers on contractual guidelines.

Qualifications

• Two years of recent accounting/finance/bookkeeping experience or an Associate’s Degree in accounting/finance/bookkeeping.
• One year prior experience as Membership Analyst I or in a Premera position with reconciliation experience.
• Health or insurance industry experience (Preferred).
• Associates or Bachelor’s degree in accounting/finance (Preferred).

Responsibilities

• Identify, resolve and document complex reconciliation discrepancies independently, processing refunds, transfers of premiums, reinstatements, and insufficient fund issues, and maintaining comprehensive notes.
• Validate accounts receivable by conducting detailed reconciliation and audit of group or individual premiums and membership.
• Utilize Access or Excel and system reports to update eligibility, enrollment and reconciliation of accounts.
• Meet or exceed department metrics: production and quality standards; stay current on policies and procedures.
• Create written correspondence regarding billing and enrollment issues.
• Research, investigate and resolve complex account discrepancies, premium rate issues, and billing problems; reproduce and create bills as needed.
• Partner with internal/external partners and members to review and resolve issues; may include portal usage and contract interpretation.
• Conduct complex electronic file accounts receivable and enrollment reconciliation.
• Educate members, brokers, or groups on membership and billing processes.
• Contact clients or state agencies to resolve electronic feed and web entry issues.
• Analyze enrollment status and apply contract provisions for each enrollment scenario.
• Validate Identification Cards are generated timely.
• Respond promptly to all member/broker/internal calls.
• Ensure compliance with federal and state regulations.
• Other duties as assigned.

Skills

Reconciliation

Excel

Access

Education

High School diploma or GED

Associate’s degree in accounting/finance

Bachelor’s degree in accounting/finance

Tools

Access

Excel

Job description

Premera Blue Cross is seeking a Membership Specialist II to perform moderate to complex reconciliation analysis and audit activities for Individual or Group accounts receivable. This role supports enrollment, billing, and premium reconciliations, working within specified hours across Pacific/Mountain/Central time zones.

The position requires strong numerical accuracy, knowledge of Access/Excel, and the ability to coach customers on contractual guidelines.