Enrollment & Billing Representative

Blue Cross of Idaho•Bozeman, MT

1d•Onsite

About The Position

Blue Cross of Idaho is seeking an Enrollment & Billing Representative (EBR) for our Meridian location. EBRs are responsible for enrollment and billing activities for our membership, by establishing and maintaining enrollment and accounts receivable records for group accounts. They also communicate with group representatives, members and applicants regarding enrollment and billing inquiries. This is an onsite position at our Meridian, Idaho location, supporting our Commercial line of business team. At this time, relocation assistance is not offered with this opportunity.

Requirements

Prior experience preferred in medical coding or billing
Strong understanding of commercial group enrollment processes
Knowledge of group billing structures (composite vs. tiered rates, retro adjustments
Experience managing employer-sponsored health plans and eligibility rule
Familiarity with premium billing, payments, and delinquency processes
Strong attention to detail when auditing eligibility files and billing report
Proficiency in Excel (v-lookups, pivot tables, basic analysis
Experience with enrollment/billing systems or CRM tools (Salesforce, Facets)
Ability to manage high-volume workloads
Preferred knowledge of COBRA, ACA, and compliance requirements
Organizational skills to manage multiple group accounts simultaneously
Adaptability in a fast-paced, deadline-driven environment
Digital literacy, such as Microsoft Office Suite, data entry and typing, using multiple software applications, general computer skills, and intranet/internet navigation.

Nice To Haves

high school diploma or equivalency, degree, and/or industry-related certification(s)
1/+ years in health industry/health insurance, general office, basic accounting, complex call center, or related experience is strongly preferred.
Preferred experience using Facets and other Blue Cross of Idaho specific software programs
Proofreading, accurately translate and code enrollment forms for entry/processing
Problem-solving, following established workflows, and assessing workflows per regulations
Communication and coordination with internal and external departments
Knowledge of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), and/or the Employee Retirement Income Security Act of 1974 (ERISA) is helpful

Responsibilities

Process membership activity by establishing records, changing, coding and entering data.
Review applications for completeness and maintain proper administration of underwriting regulations on eligibility and acceptance of premiums.
Assure prompt, complete and accurate reconciliation of daily income by researching and adjusting membership records and reconciling paid bills/coupons.
Send correspondence and collect premiums on delinquent accounts.
Maintain eligibility and billing on the Facets system.
Receive, research and reply to telephone, written and electronic inquiries related to enrollment and billing, within corporate and departmental guidelines.
Correspond with members, as required (usually email or phone).
Research enrollment requests for completeness timelines and applicable regulations.
Performs quality checks on enrollment processing transactions, providing input and updates to workflows, training programs and quality assurance tools, as required.
Assures all documents are properly coded and prepared for the Image/Archive System.
Maintain knowledge of federal regulations including, but not limited to the following: HIPAA, COBRA and ERISA.
Complies with all local, state and federal regulations.