Membership Representative

Blue Cross and Blue Shield of North Carolina•Remote Flex - North Carolina, NC

1d•$41,600 - $66,561•Hybrid

About The Position

We’re hiring a Membership Representative to join the Membership Services Team! This role is responsible for managing group and/or member enrollment and eligibility activities, and maintaining accurate membership records. The Membership Representative will perform standard and moderately complex group level/or member-level enrollment for medical and ancillary products in accordance with established procedures. They will maintain accurate, timely membership and eligibility records across multiple systems, ensuring data integrity and compliance. This role will also address eligibility issues by applying applicable federal and state regulations and internal and external governance requirements, and research and respond to enrollment errors via telephone or written communication, clearly documenting issues, corrective actions taken, and applicable policies or procedures. Additionally, the Membership Representative will receive and place calls to respond to questions, obtain information, and resolve inquiries related to membership, enrollment, group and individual records, and contracts. They will support agents, benefits administrators, and members with general billing and enrollment questions, and process back-end error reports for electronic enrollment reports, ensuring timely identification, resolution, and documentation of discrepancies.

Requirements

High school diploma or GED
0-2 years of experience in related field.

Nice To Haves

Accounts Payable Process
Answering Telephones
Benefits Administration
Billing
Billing Process
Billing Reconciliation
Customer Care
Customer Service
Data Entry
Email Management
Enrollment Management
Health Insurance
Insurance Administration
Member Retention
Relationship Building
Sales
Student Enrollment

Responsibilities

Enroll and renew groups and members, and maintain accurate membership records, including additions, deletions, and changes and terminations for the health plans.
Perform standard and moderately complex group level/or member-level enrollment for medical and ancillary products in accordance with established procedures.
Maintain accurate, timely membership and eligibility records across multiple systems, ensuring data integrity and compliance.
Address eligibility issues by applying applicable federal and state regulations and internal and external governance requirements.
Research and respond to enrollment errors via telephone or written communication, clearly documenting issues, corrective actions taken, and applicable policies or procedures.
Receive and place calls to respond to questions, obtain information, and resolve inquiries related to membership, enrollment, group and individual records, and contracts.
Support agents, benefits administrators, and members with general billing and enrollment questions.
Process back-end error reports for electronic enrollment reports, ensuring timely identification, resolution, and documentation of discrepancies.