PacificSource Health Plans-posted about 1 year ago
Full-time • Entry Level
Boise, ID
Insurance Carriers and Related Activities

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.

  • Process group enrollment applications, changes, terminations, waivers, and continuation forms for subscribers and dependents.
  • Provide customer service by phone and e-mail to group administrators, brokers, and members.
  • Review daily payments and reconcile accounts.
  • Establish relationships with administrators and attend renewal meetings.
  • Assist members, agents, and group administrators with eligibility, regulations, COBRA & state continuation administration, and demographic changes.
  • Process manual deposits and prepare setup, staging, and spreadsheet with daily totals to 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 and distribute information for processing.
  • Complete all daily, weekly, bi-monthly, and monthly reports.
  • 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, Accounting/Accounts Receivable preferred.
  • Basic math skills required, including percentages, ratios, and spreadsheet skills.
  • Knowledge of Health Savings Account contracts.
  • Health insurance coverage
  • 401k retirement savings plan
  • Paid holidays
  • Flexible scheduling options
  • Professional development opportunities
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