Membership Representative

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

6d•$41,600 - $66,561•Hybrid

About The Position

Responsible for administering member and group enrollment, eligibility, and membership activities to ensure accurate and compliant membership records across health plan products. Performs enrollment transactions, resolves eligibility and billing issues, researches and corrects discrepancies, and provides support to members, agents, and benefits administrators. Maintains data integrity across multiple systems while ensuring adherence to regulatory requirements, operational procedures, and service standards. Facilitates timely resolution of enrollment, billing, and membership inquiries to support an accurate and positive member experience.

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
Process billing inquiries and reconciliation activities. including researching billing discrepancies and initiating corrections or reverse transactions as needed.
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.