COBRA & Premium Billing Admin I

Lifetime Benefit Solutions•Buffalo, NY

19h

About The Position

The COBRA & Premium Billing Administrator responds to and resolves written, telephone, and in-person inquiries from clients and subscribers about policies and procedures. The position coordinates and monitors daily COBRA and Third-Party Premium Billing Administration activities to ensure regulatory requirements, service standards, and deadlines are met. The role supports clients and brokers with day-to-day operations, including inquiries, reporting, refunds, open enrollment, grace periods, payments, rate renewals, and training on software and portal functionality. It also processes membership file exchanges and coordinates carrier files for coverage reinstatements, changes, and terminations, working with clients, brokers, vendors, carriers, and the EDI team to resolve file and billing issues. At Level I, the administrator maintains knowledge of applicable rules and benefits, administers group plans, supports customer service research, processes member requests, assists with system testing, follows and contributes to desk-level procedures, and meets productivity and service standards. Level II adds advanced research and resolution, escalated issue support, audit assistance, strategic and complex account servicing, and serving as a resource to other team members. The position requires working at a workstation using a computer, keyboard, mouse, and/or phone for periods of three or more hours, and the ability to hear, understand, and speak clearly while using a phone. Remote work may be possible on a case-by-case basis.

Requirements

High school diploma or equivalent.
At least two years of related experience for Level I.
General understanding of medical, dental, vision, and Medicare benefits.
Excellent problem-solving, reasoning, and organizational skills, with the ability to manage multiple projects.
PC experience, including Microsoft Word and Excel.
Excellent oral and written communication skills.
Ability to communicate effectively, work collaboratively, and maintain positive client relationships.
Ability to work both independently and as part of a team.
For Level II, at least four years of experience in the COBRA and Premium Billing industry.
For Level II, strong knowledge of COBRA and Premium Billing rules and regulations, demonstrated ability to resolve complex inquiries or escalated situations, and advanced knowledge of the departmental software system and Excel.
Ability to work sitting and/or standing at a workstation while viewing a computer and using a keyboard, mouse, and/or phone for three or more hours at a time.
Ability to hear, understand, and speak clearly while using a phone, with or without a headset.

Nice To Haves

Associate degree in business administration or a related field.
Knowledge of COBRA rules and regulations.

Responsibilities

Respond to and resolve client, broker, and subscriber inquiries about policies and procedures within service standards.
Coordinate day-to-day client and broker operations, including reporting, member refunds, open enrollment requests, grace periods, payment requests, and payment-status reporting.
Notify and educate clients about changes to rules and regulations.
Conduct webinar demonstrations and support client and broker training on software and portal functionality.
Manage rate renewals for assigned clients and participate in requested client and broker conference calls.
Process inbound and outbound departmental file exchanges, including membership file additions, updates, deletions, and identified error or no-load files.
Coordinate daily carrier files for member coverage reinstatements, changes, and terminations.
Collaborate with the LBS EDI team to identify and resolve file errors, and communicate with clients, brokers, or vendors about file-processing issues.
Support the establishment and testing of new client files and monitor and document carrier preferred eligibility processes.
Work with carriers to ensure billing activities meet client and carrier needs.
Maintain knowledge of COBRA and Premium Billing rules, regulations, policies, and benefits; administer group plans and process activity within service standards.
Support the customer service team by researching and responding to member inquiries.
Process member requests not handled through the software vendor, including payments, banking forms, and enrollment and termination forms.
Assist with system and release testing and troubleshooting.
Perform team and departmental functions according to desk-level procedures and participate in developing, updating, and monitoring those procedures.
Participate in ongoing training and maintain current knowledge of LBS policies and procedures.
Meet productivity metrics and inter-departmental assignment standards, maintain member privacy, and demonstrate the company's mission, values, and Code of Conduct.
Maintain regular and reliable attendance and perform other functions as assigned by management.
At Level II, conduct advanced research and resolve inquiries and adjustments for clients, brokers, or carriers; assist with escalated or systematic issues; identify error trends; assist with audits and data comparisons; service strategic and complex accounts; and serve as a resource to team members.