Membership Specialist III

Workforce Classification:
Telecommuter
Join Our Team: Do Meaningful Work and Improve People’s Lives

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: .

As a Membership Specialist III , you will help ensure members can access and use their health coverage with confidence. By completing accurate enrollment work, resolving complex account and reconciliation issues, and applying contractual and regulatory requirements, you will reduce disruptions and create a simpler, more reliable experience for the people we serve. Your analysis will also uncover root causes and drive process improvements that strengthen accuracy, efficiency, and service across multiple lines of business.
What you will do:

- Review plan provisions and apply specific rules inherent to the line of business. Apply contractual, state and federal guidelines as appropriate (i.e., Affordable Care Act, Senior Markets, and Member Touchpoint Measures/MTM), ensuring work is in compliance with federal and state regulations.

- Research, investigate and resolve complex account discrepancies and financial reconciliation between company systems and/or third party vendor systems.

- Identify improvement opportunities, recommend solutions, and mitigate issues throughout analysis.

- Develop and maintain requirements within Premera systems encompassing the specific line of business.

- Participate in user acceptance testing and support roll out of new processes, features and tools.

- Effectively communicate specific plan requirements with internal/external business partners and/or customers.

- Develop and maintain relationships with internal stakeholders cross functionally.

- Other responsibilities as assigned.

What you will bring:

- A combination of three (3) years of experience in customer service, accounting, finance, and/or billing (Required).

- An Associates or Bachelor's Degree in accounting/finance.

- Healthcare or insurance industry experience.

- Experience in Premera Customer Service or Membership & Billing.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

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Medical, vision, and dental coverage with low employee premiums.

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Voluntary benefit offerings, including pet insurance for paw parents.

- Life and disability insurance.

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Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.

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Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.

- Generous paid time off to reenergize.

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Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

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Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resourc