Senior Membership Billing Rep-TPA

Medical Mutual•Cleveland, OH

3d•Remote

About The Position

Under limited supervision, provides administrative support in the membership and billing areas. Maintains member health plan records and sends monthly invoices to clients for administration fees associated with their employee benefit plan. Functions as the first point of contact for internal clients, groups and brokers regarding routine to varied and/or complex eligibility and billing inquiries. Serves as a resource to more junior level Representatives and assists management with special projects as needed.

Requirements

Bachelors’ Degree in Business Administration, Communications or related field preferred, but will consider collective experience, training and education.
3 years' experience as a Membership/Billing Representative or equivalent experience in health insurance membership and/or billing, preferably in a third party administration environment.
Health Care field certification a plus (i.e. medical terminology, certified coder/biller, etc.)
Strong knowledge of health insurance products, medical terminology, premium ratings and eligibility administration.
Intermediate to advanced proficiency with Microsoft Office and health insurance operations systems.
Strong math skills.
Ability to interpret documents of varied complexity.
Solid data entry skills.

Responsibilities

Processes routine to varied and/or complex member enrollment transactions such as group additions, terminations, renewals, etc.
Prepares routine to varied and/or complex invoices and reports.
Reviews/updates open enrollment changes such as Coordination of Benefits (COB), dependent updates, etc.
Researches and responds to routine to varied and/or more complex eligibility inquiries via fax, postal mail or e-mail regarding eligibility feeds and files, and eligibility issues on vendor websites (i.e dental, RX, vision).
Creates and executes system test plans/scripts, system upgrades, and/or new releases.
Participates frequently in onsite and phone client implementation meetings to provide sales support.
Verifies proper and timely review and approval of enrollment information submitted by customers via the secured website within expected turnaround times.
Verifies proper coordination and documention of correspondence and distribution into workflow.
Orients, trains and assists more junior level Representatives, and collaborates with other departments on group set ups, providing assistance as needed.
Analyzes deficiencies in processes/procedures and recommends improvements to management and implements with management approval.
Performs other duties as assigned.

Benefits

Laptop, monitors, keyboard, mouse and headset provided
Access to on-site fitness centers or gym membership reimbursement
On-site cafeteria
Discounts at many places in and around town
Opportunity to earn cash rewards for shopping with customers
Business casual attire, including jeans
Employee bonus program
401(k) with company match up to 4% and an additional company contribution
Health Savings Account with a company matching contribution
Medical, dental, vision, life and disability insurance
Employee Assistance Program
Company holidays
Up to 16 PTO days during the first year of employment with options to carry over unused PTO time
Parental leave for eligible employees who become parents through maternity, paternity or adoption (after 120 days of service)
Career development programs and classes
Mentoring and coaching
Tuition reimbursement up to $5,250 per year
Diverse, inclusive and welcoming culture with Business Resource Groups