Membership Specialist II

Premera Blue Cross•WA Other Telecommuter, WA

4d•$41,500 - $71,100•Remote

About The Position

The Membership Specialist II performs moderate to complex reconciliation analysis and audit activities for Individual or Group accounts receivable. Using reconciliation databases, receipts, electronic file reconciliation, and basic accounting principles, this role resolves enrollment, reconciliation, and billing issues with minimal supervision. The position also supports coaching internal and external customers on contractual guidelines. Its work contributes to managing financial risk and supporting member satisfaction. The role is limited to employees in Pacific, Mountain, or Central time zones, working between 7 a.m. and 5 p.m. Pacific Time. The position is classified as a telecommuter.

Requirements

High school diploma or GED.
Two years of recent accounting, finance, or bookkeeping experience, or an associate degree in accounting, finance, or bookkeeping.
One year of prior experience as a Membership Analyst I or in a Premera position with reconciliation experience.

Nice To Haves

Health or insurance industry experience.
Associate or bachelor's degree in accounting or finance.

Responsibilities

Independently identify, resolve, and document complex reconciliation discrepancies; process refunds, premium transfer requests, reinstatements, and insufficient-fund issues; make enrollment or eligibility changes as needed; and maintain accurate notes.
Validate accounts receivable by conducting detailed reconciliations and audits of group or individual premiums and membership.
Use appropriate tools and system reports, including Access or Excel, to update eligibility, enrollment, or account reconciliations.
Meet or exceed department production and quality metrics and remain current on company and departmental policies and procedures.
Create written correspondence using the appropriate system regarding billing and enrollment issues.
Research, investigate, and resolve account discrepancies, premium rate issues, bill-flag suspensions or corrections, and billing issues; reproduce or create customized or manual bills as needed; and maintain and report inventories accurately and on time.
Partner with internal and external partners and members to review and resolve issues, including matters involving web portal usage and contract interpretation.
Conduct complex electronic-file accounts receivable and enrollment reconciliation.
Educate members, brokers, and groups on membership and billing processes, administrative rules, portal usage, and contract or policy interpretation.
Contact clients or state agencies to resolve high volumes of electronic-feed or web-entry issues identified through internal reporting.
Analyze enrollment status and apply contract provisions to enrollment scenarios, update records, and research and resolve enrollment system rejections.
Validate that identification cards are generated in a timely manner.
Respond promptly to incoming and outgoing phone calls from members, brokers, and internal departments.
Ensure compliance with federal and state regulations.
Perform other duties as assigned.

Benefits

Medical, vision, and dental coverage with low employee premiums.
Voluntary benefits, including pet insurance.
Life and disability insurance.
Retirement programs, including a 401(k) employer match and a pension plan vested after three years of service.
Wellness incentives and mental well-being resources, including counseling, stress management, and mindfulness programs.
Generous paid time off.
Tuition assistance for undergraduate and graduate degrees.
Employee recognition program.
For hybrid employees, access to on-campus resources, networking opportunities, and team engagement.
Commuter perks.
Free on-site parking.
Subsidized on-campus cafes.
On-site activities, including health and wellness events, coffee connects, and disaster preparedness fairs.
Fitness and well-being center with in-person and virtual workouts and nutritional counseling.