Group Membership Representative I

PacificSource Health Plans • Springfield, OR

402d

About The Position

The Group Membership Representative I at PacificSource Health Plans is responsible for administering commercial fully insured group accounts, processing enrollment and disenrollment transactions, and providing customer service to group administrators, brokers, and members. This entry-level position requires strong organizational skills and the ability to manage multiple tasks while ensuring accuracy in account management and compliance with regulations.

Requirements

• High school diploma or equivalent required.
• Minimum of one year prior customer service experience with basic Excel skills required.
• Strong keyboarding and 10-key experience, with accounting/accounts receivable preferred.
• Basic math skills required, including percentages and ratios.
• Excellent verbal, telephone, and written communication skills.

Nice To Haves

• Knowledge of Health Savings Account contracts.
• Experience in a healthcare or insurance environment.

Responsibilities

• Process group enrollment applications, changes, terminations, waivers, and continuation forms for subscribers and dependents.
• Provide customer service by phone and email to group administrators, brokers, and members.
• Review daily payments and reconcile accounts.
• Establish relationships with administrators and attend renewal meetings.
• Log into group department phone queues and document all calls, responding to daily emails and voicemails.
• Assist members, agents, and group administrators with eligibility, regulations, and demographic changes.
• Process manual deposits and prepare setup and staging for Finance.
• Reconcile group balances and process Claims Pay Holds, Rating Overrides, and refunds as needed.
• Maintain State or Federal Exchange group accounts and contact groups scheduled to term due to non-payment.
• Monitor the representative and department RightFax and email queues for processing information.

Benefits

• Health insurance
• 401k plan
• Paid holidays
• Paid time off
• Professional development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED