Membership Admin Account Specialist-1

BlueCross BlueShield of Tennessee • Chattanooga, TN

6d • Remote

About The Position

The Membership Account Specialist supports Medicare membership by ensuring accurate and timely enrollment processing, eligibility maintenance, and issue resolution. The role researches and resolves complex membership and enrollment discrepancies, processes Medicare transactions in compliance with CMS regulations, and collaborates with internal and external partners to support a seamless member experience. It serves as a subject matter expert for Medicare enrollment and billing processes, supports operational initiatives, analyzes account-related issues, and helps maintain accurate membership data. This is a remote, Monday–Friday position with standard business hours; the employee is expected to work independently and collaborate with cross-functional teams.

Requirements

• High school diploma or equivalent.
• At least 1 year of experience in the healthcare industry.
• Proficiency in Microsoft Outlook, Word, Excel, and PowerPoint.
• Proficient oral and written communication skills.
• Proficient interpersonal and organizational skills.
• Strong analytical, problem-solving, and organizational skills.
• Thorough understanding of Medicare enrollment regulations and membership operations.
• Detail-oriented, customer-focused approach and ability to navigate complex scenarios.

Responsibilities

• Implement appropriate filing and documentation procedures and keep physical and electronic files current and accurate.
• Communicate with underwriters, agents, loss control specialists, and other relevant parties to receive and share policy and case information; use that information to improve services, anticipate and prevent problems, or suggest improvements.
• Meet assigned quality and workload expectations and implement procedural revisions or improvements as needed.
• Ensure production, timeliness, and quality standards are met.
• Process assigned policies and cases according to department procedures and expectations.
• Respond to complaints and inquiries and identify and resolve difficulties in membership and benefits services.
• Research and resolve membership and enrollment discrepancies and process Medicare transactions in compliance with CMS regulations.
• Collaborate with internal and external partners to support members and maintain accurate membership data.

What This Job Offers

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