COBRA & Premium Billing Admin I

Univera Healthcare • Buffalo, NY

7h

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. Multiple classification levels are described, with Level II involving greater independence, complexity, responsibility, and serving as a resource to other team members.

The role supports client and broker operations, membership file exchanges and enrollment, carrier billing activities, and member inquiries. It administers group plans in accordance with applicable regulations and procedures, maintains member privacy, and participates in training, system testing, and process documentation. The company describes a mission focused on healthier communities and an I.D.E.A. mindset: Inclusion, Diversity, Equity, and Access. It encourages applications from people of color, LGBTQ+ people, people with disabilities, veterans, and other underrepresented groups.

Requirements

• High school diploma or equivalent.
• Two or more 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 and maintain positive relationships while working collaboratively with clients.
• Ability to work both in a team environment and independently.
• For Level II, four or more years of experience working in the COBRA and Premium Billing industry.
• For Level II, demonstrated problem-solving ability and capacity to resolve complex inquiries or escalated situations.
• For Level II, 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.
• Strong knowledge of COBRA and Premium Billing rules and regulations for Level II.

Responsibilities

• Serve as a point of contact for clients and brokers on day-to-day operational tasks, including inquiries and requests, client reporting, member refunds, open enrollment, grace periods, member payment requests, and member payment status.
• Respond to client and broker inquiries within department service standards and notify and educate clients about rule or regulation changes.
• Conduct webinar demonstrations and support client and broker training on software and portal functionality.
• Manage the rate renewal process for assigned clients.
• Participate in conference calls requested by clients and brokers.
• Process inbound and outbound departmental file exchanges within service standards, including membership file updates 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 proactively.
• 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 rules, regulations, policies, and benefits governing COBRA and Premium Billing.
• Administer group plans in accordance with applicable regulations and process activity within service time standards.
• Support the customer service team by answering or researching member inquiries; research, interpret, and respond professionally and efficiently using problem-solving skills.
• Process member requests not facilitated through the software vendor, including payments, banking forms, and enrollment and termination forms.
• Assist with system and release testing and troubleshooting.
• Perform departmental and team functions according to desk-level procedures, and participate in their development, updating, and monitoring.
• Participate in ongoing training and develop knowledge of regulations, software systems, policies, and procedures.
• Meet departmental and team productivity metrics and satisfy assigned inter-departmental team tasks and standards.
• Maintain current knowledge of LBS policies and procedures and uphold the company's Code of Conduct, mission, and values.
• Maintain member privacy in accordance with corporate privacy policies and procedures.
• 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; and proactively 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.
• Competitive compensation and benefits.

What This Job Offers

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