Membership Administrator I - III, DOE

Membership Administrator I – III, DOE

Work from home within Oregon, Washington, or Idaho

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.  

Who We Are Looking For: 

Every day, Cambia’s dedicated team of Membership Administrators are living our mission to make health care easier and lives better. As a member of the Customer & Member Services Operations team, our Membership Administrator establishes and maintains eligibility, bills premium, reconciles cash and member discrepancies, pursues aged accounts and provides eligibility and billing-related customer service for Individual, Group, Government Programs, Cobra and Flexible Spending business.

Do you thrive as a part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia: 

Qualifications:  

The Membership Administrator I would have a High School diploma or GED and one-year accounts receivable or customer billing experience or an equivalent combination of education and job-related work experience.

The Membership Administrator II would have a High School diploma or GED and one year experience as Membership Administrator I performing all duties at the Core or higher performance level or an equivalent combination of education and job-related work experience.

The Membership Administrator III would have a High School diploma or GED and 18 months as a Membership Administrator II performing at the Core or higher performance level or an equivalent combination of education and job-related work experience.

Skills and Attributes: 

• 30 wpm with 95% accuracy typing skills.

• 10-key by touch (8500 keystrokes per hour with 95% accuracy preferred).

• PC experience – Word, Excel and Outlook – or comparable software – and ability to learn and use complex systems.

• Strong math skills (mathematical calculations and concepts), judgment and other resources to implement effective problem solving.

• Ability to coordinate and prioritize work.

• Must be diligent and self-motivated.

• Must be conscientious and maintain attendance at or above departmental standards.

• Ability to exercise judgment, initiative and discretion in confidential, mature and sensitive manner.

• Ability to communicate effectively both orally and in writing.

• Ability to establish effective working relationships with staff and customers

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia:  

• Process enrollment applications for individuals and groups, calculating eligibility data, effective dates, and entering member information consistent with contracts.

•  Review and maintain account changes including effective dates, additions/deletions of members, and verify information through calls to employers, subscribers, or carriers as needed.

• Provide customer service through written correspondence and phone inquiries, making necessary corrections while ensuring member confidentiality.

• Perform eligibility and reconciliation tasks accurately and timely, including generating and reviewing billings, processing cash, and monitoring aged accounts to meet corporate standards.

•  Order and audit member cards for accuracy, including corporate logos, lines of business co-pay, PCP, and member card comments.

• Apply corporate underwriting guidelines, governmental regulations, and updated policies to ensure compliance with federal, state, BCBSA and accreditation requirements.

• Coordinate electronic data transfer with external entities including CMS, employer groups, agents, and vendors; assist with system testing as needed.

•  Support team operations by providing phone coverage, assisting with clerical tasks, participating in training, and working overtime when required.