Enrollment & Billing Representative (Individual)

locationMeridian - Idaho (ID),

atBlue Cross of Idaho

Estimated salary $18 an hour

Job Description:

Responsible for enrollment and billing activities for the membership for individual accounts. Establish and maintain enrollment and accounts receivable records for group or individual accounts. Communicate with members and applicants regarding enrollment and billing inquiries.

Required Experience: none required; strong preference for 1/+ years in health industry, general office, basic accounting, or related experience.

Education: No specific educational requirement for this position. Preference for highschool diploma or equivalency, degree, and/or industry-related certification(s).

Skills & Abilities:

  • Digital literacy, such as Microsoft Office Suite, data entry and typing, using multiple software applications, general computer skills, and intranet/internet navigation. Preferred experience using Facets and other Blue Cross of Idaho specific software programs

  • Proofreading and accurately translate and code enrollment forms for entry

  • Problem-solving, following established workflows, and assessing workflows per regulations

  • Communication and coordination with internal and external department

Preferred qualifications:

  • Knowledge of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), and/or the Employee Retirement Income Security Act of 1974 (ERISA)

Your day may look like:

  • Process membership activity by establishing records, changing, coding and entering data. Review applications for completeness and maintain proper

administration of underwriting regulations on eligibility and acceptance of premiums.

  • Assure prompt, complete and accurate reconciliation of daily income by researching and adjusting membership records and reconciling paid bills/coupons. Send correspondence and collect premiums on delinquent accounts. Maintain eligibility and billing on the Facets system.

  • Receive, research and reply to telephone, written and electronic inquiries related to enrollment and billing, within corporate and departmental guidelines. Issues correspondence to members, as required. Researches enrollment requests for completeness timelines and applicable regulations.

  • Performs quality checks on enrollment processing transactions, providing input and updates to workflows, training programs and quality assurance tools, as required. Assures all documents are properly coded and prepared for the Image/Archive System.

  • Maintain knowledge of federal regulations including, but not limited to the following: HIPAA, COBRA and ERISA. Complies with all local, state and federal regulations.

  • Perform other duties and responsibilities as assigned.

  • Position Reports to: Supervisor Service Operations - Enrollment & Billing (Individual)

    Internal Job Posting: 12/8/2020 - 12/15/2020

    External Job Posting: 12/8/2020 - Until Filled

    We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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