COBRA & Premium Billing Admin I

Excellus BCBS • Buffalo, NY

14h

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 administrator serves as a day-to-day contact for clients and brokers, handles requests and reporting, processes member refunds and payment requests, manages open enrollment and rate renewals, and monitors grace periods and payment status. The role also processes membership file exchanges and works with clients, brokers, vendors, carriers, and the EDI team to resolve file issues and maintain coverage information.

The role administers group plans in accordance with applicable regulations, supports customer service research, processes member requests, assists with system testing and troubleshooting, and follows departmental procedures and productivity standards. The posting describes Level II duties and qualifications as additional to Level I, including advanced research, escalated issue resolution, client audits, strategic and complex accounts, and serving as a team resource.

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.
• Strong problem-solving, reasoning, organizational, and project-management skills.
• PC experience, including Microsoft Word and Excel.
• Excellent oral and written communication skills.
• Ability to communicate effectively and maintain positive client relationships while working collaboratively.
• Ability to work both independently and in a team environment.
• For Level II, at least four years of experience in the COBRA and Premium Billing industry.
• For Level II, demonstrated problem-solving skills and ability to resolve complex inquiries or escalated situations.
• For Level II, advanced knowledge of the departmental software system and Excel.
• Ability to work seated 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.
• For Level II, strong knowledge of COBRA and Premium Billing rules and regulations.

Responsibilities

• Serve as a point of contact for clients and brokers on day-to-day operational tasks, including inquiries, reporting, member refunds, open enrollment, grace periods, payment requests, and payment-status reporting.
• Respond to client and broker inquiries within department service standards and educate clients about rule or regulation changes.
• Conduct webinar demonstrations and support client and broker training on software systems and portal functionality.
• Manage rate renewals for assigned clients and participate in client- and broker-requested conference calls.
• Process inbound and outbound departmental files within service standards, including membership additions, updates, deletions, and identified error or no-load files.
• Coordinate and execute 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 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 time standards.
• Support customer service staff by answering or researching member inquiries and responding professionally using problem-solving skills.
• Process member requests not facilitated through the software vendor, including payments, banking forms, enrollment forms, and termination forms.
• Assist with system and release testing and troubleshooting.
• Follow, develop, update, and monitor departmental and team desk-level procedures.
• Participate in ongoing training and meet departmental and team productivity metrics and interdepartmental assignment standards.
• Maintain knowledge of LBS policies and procedures, uphold the Corporate Code of Conduct and Lifetime Way values, protect member privacy, and maintain regular and reliable attendance.
• Perform other functions as assigned by management.
• At Level II, conduct advanced research and resolve inquiries and adjustments for clients, brokers, or carriers; help resolve escalated or systematic issues and identify error trends.
• At Level II, assist with client audits and data comparisons, service strategic and complex accounts, and serve as a resource to team members.

Benefits

• Group health and/or dental insurance may be included in the total rewards package.
• Retirement plan may be included in the total rewards package.
• Wellness program may be included in the total rewards package.
• Paid time away from work may be included in the total rewards package.
• Paid holidays may be included in the total rewards package.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED