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Member Admin Account Specialist


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Location

Chattanooga, TN | United States


Job description

Qualifications: All applicants will be advised that BlueCross, as a federal contractor, may be required to implement a COVID-19 vaccine mandate. Education High School Diploma or equivalent Experience 2 years of experience in the healthcare industry required Skills/Certifications Proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint and Access) Proficient oral and written communication skills Proficient interpersonal and organizational skills Responsibilities: Job Duties and Responsibilities Perform complete lifecycle of member enrollment; including but not limited to enrollments, exception decisions, changes and terminations within the automated workflow system, or manually if request is in paper form within specified timeframes outlined and based on applicable documents (contracts, federal/state mandates, etc). Selection of appropriate underwriting options for employer group member life enrollment applications (new and changes) and Medicare supplement applications as appropriate Successfully load membership data into third party Rx system and order ID cards as appropriate Reconcile billed amounts to amounts paid by the group or member and identify any discrepancies. Maintain proper records of payment receipts, refunds, COBRA notifications and other transactions to assure proper audit trails for compliance purposes Manage various billings for member and/or group accounts, payments, reconciliations and/or recoupment of expenses including, but not limited to, BCBST branded products, GIS specialty products, BlueCard fees, administrative fees and special services manually billed as discretionary billing items. This includes ARCH debit and wire transactions. Know and apply COBRA rules to assure compliance with DOL and ERISA regulations including, but not limited to, those where financial penalties are at risk. Manage member contribution allocations for HRA and HSA products. Promote continuity of existing business through effective interaction with members, Group Administrators, other BCBS Plans, Regional Service Specialists, Marketing (Sales and Account Executives), Brokers, and Third Party Administration (TPAs). Complete weekly inventory and productivity reports in a timely and accurate manner. Provide internal and external technical support for any special projects that are deemed necessary to support Division and or corporate activities.


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For contractors


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