ASO Membership Administrator I - III, DOE

Cambia Health • Bend, OR

60d • $18 - $34 • Remote

About The Position

Every day, Cambia's dedicated team of Membership Administrators are living our mission to make health care easier and lives better. As a member of the Customer and Member Services Operations team, our Membership Administrator establishes and maintains eligibility, bills premium, reconciles cash, pursues aged accounts and provides eligibility and billing related customer service for Individual, Group, Government Programs, Cobra and Flexible Spending business - all in service of creating an economically sustainable health care system. Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit.

Requirements

• High School diploma or GED
• One year accounts receivable or customer billing experience or an equivalent combination of education and job-related work experience for Membership Administrator I
• One year experience as Membership Administrator I performing all duties at the Core or higher performance level or an equivalent combination of education and job-related work experience for Membership Administrator II
• 18 months as a Membership Administrator II performing at the Core or higher performance level or an equivalent combination of education and job-related work experience for Membership Administrator III
• 30 wpm with 95% accuracy typing skills
• 10-key by touch (8500 keystrokes per hour with 95% accuracy preferred)
• PC experience - Word, Excel and Outlook - or comparable software - and ability to learn and use complex systems
• Strong math skills (mathematical calculations and concepts), judgment and other resources to implement effective problem solving
• Ability to organize and prioritize work
• 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 communicate effectively both orally and in writing
• Must be able to establish effective working relationships with staff and customers

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

Responsibilities

• Process enrollment applications for individuals and groups, including calculating waiting periods, entering member data, benefits information, and ensuring compliance with employer/individual contracts
• Maintain and update member accounts by processing changes such as effective dates, adding/removing members from coverage, and making necessary corrections or adjustments
• Conduct outreach communications to employers, and agents to verify information needed for complete application processing
• Provide comprehensive customer service to internal and external customers through written correspondence and telephone support, resolving inquiries and issues
• Perform eligibility verification and reconciliation tasks accurately and timely, identifying payment discrepancies and ensuring proper billing processes
• Generate and review billing statements for accuracy before distribution
• Order/audit member cards against applications for correct information and corporate branding
• Apply underwriting guidelines and regulatory compliance including corporate policies and state/federal regulations, particularly for government programs
• Manage cash processing and aged accounts through daily reconciliation to meet corporate turnaround standards and reporting requirements
• Coordinate data transfers and system testing with external entities (CMS, employers, agents, vendors) while ensuring compliance with quality and timeliness standards
• Support departmental operations through backup coverage, clerical tasks, training participation, overtime work as needed, and maintaining member confidentiality throughout all processes
• Execute advanced eligibility and reconciliation tasks including detailed research, problem-solving, auditing complex issues, and ensuring accurate financial reporting for all account types including self-funded accounts
• Provide leadership and training support by coaching and mentoring staff at all levels, conducting professional presentations for employer groups and agents, and serving as a role model for ethical work practices
• Maintain regulatory compliance and documentation by keeping current with state and federal regulations (especially for government programs), updating policy manuals, and responding to state insurance commission inquiries
• Support system development and quality initiatives through creating test cases, assisting with user acceptance testing, participating in process improvement teams, and completing RFPs for account optimization
• Represent the division professionally by attending and facilitating internal/external meetings, assisting supervisors and leads as needed, and coordinating cross-functional activities to meet corporate standards

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees