COBRA & Premium Billing Admin I

company • City of Utica, NY

3d • $20 - $27

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 role coordinates and monitors daily COBRA and Third-Party Premium Billing Administration activities to ensure regulatory requirements, standards, and deadlines are met.

The position supports clients, brokers, carriers, vendors, and members through operational service, file and enrollment processing, coverage administration, inquiry resolution, and account support. The job description includes Level I and Level II responsibilities, with Level II adding advanced research, escalated issue resolution, strategic and complex account servicing, and support for other team members.

The Lifetime Healthcare Companies describe a mission centered on healthier communities and an I.D.E.A. mindset: Inclusion, Diversity, Equity, and Access. The organization encourages applicants from underrepresented groups and describes its culture as grounded in compassion, pride, excellence, innovation, and having fun. The employer offers competitive compensation and benefits. Remote work may be possible on a case-by-case basis.

Requirements

• Level I: High school diploma or equivalent.
• Level I: Two or more years of related experience.
• Level I: General understanding of medical, dental, vision, and Medicare benefits.
• Level I: Excellent problem-solving, reasoning, and organizational skills, with the ability to manage multiple projects.
• Level I: PC experience, including Microsoft Word and Excel.
• Level I: Excellent oral and written communication skills.
• Level I: Ability to communicate effectively, collaborate, and maintain positive client relationships.
• Level I: Ability to work both independently and in a team environment.
• Level II: Four or more years of experience in the COBRA and Premium Billing industry.
• Level II: Strong knowledge of COBRA and Premium Billing rules and regulations.
• Level II: Demonstrated problem-solving ability, including resolving complex inquiries or escalated situations.
• Level II: Advanced knowledge of the departmental software system and Excel.
• Physical requirement: Ability to sit and/or stand at a workstation while viewing a computer and using a keyboard, mouse, and/or phone for three or more hours at a time.
• Physical requirement: 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 preferred.
• Knowledge of COBRA rules and regulations preferred.

Responsibilities

• Serve as a point of contact for clients and brokers on day-to-day operational tasks, including responding to inquiries and requests, arranging and delivering reporting, processing member refunds, managing open enrollment and grace periods, handling member payment requests, and reviewing and reporting payment status.
• Respond to client and broker inquiries within department service standards and explain changes to rules or regulations.
• Conduct webinar demonstrations and support client and broker training on software and portal functionality.
• Manage rate renewals for assigned clients.
• Participate in client- and broker-requested conference calls.
• Process inbound and outbound departmental file exchanges, including membership file changes 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.
• Communicate with clients, brokers, and vendors to resolve file-processing issues.
• Support the establishment and testing of new client files.
• Monitor and document each carrier's preferred eligibility process.
• Work with carriers to ensure billing activities meet client and carrier needs.
• Maintain knowledge of regulations, policies, and benefits governing COBRA and Premium Billing; administer group plans in accordance with regulations and service time standards.
• Support the customer service team by researching and answering member inquiries professionally and efficiently.
• Process member requests not handled through the software vendor, including payments, banking forms, enrollment forms, 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 develop the skills needed to fulfill job requirements accurately.
• Meet departmental and team productivity metrics and complete assigned interdepartmental tasks to established standards.
• Maintain current knowledge of LBS policies and procedures and uphold the organization's mission, values, Code of Conduct, and privacy policies.
• Maintain regular and reliable attendance and perform other functions as assigned by management.
• At Level II, conduct advanced research and resolve client, broker, or carrier inquiries and adjustments.
• At Level II, assist with escalated or systemic issues and proactively identify error trends.
• At Level II, assist with client audits and data comparisons.
• At Level II, service strategic accounts and complex COBRA and Premium Billing accounts.
• At Level II, serve as a resource to other team members.

Benefits

• The posting describes potential participation in group health and/or dental insurance, a retirement plan, a wellness program, paid time away from work, and paid holidays.
• Competitive compensation and benefits are offered.

What This Job Offers

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