What are the responsibilities and job description for the Processor ii position at Cambia Health Solutions, Inc.?
Membership Eligibility Processor I, II, or III, DOE
Work from home within Oregon, Washington, Idaho or Utah
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 Member Eligibility Processors are living our mission to make health care easier and lives better.
As a member of the Membership team, our Membership Eligibility Processors establish and maintains accurate subscriber and member level eligibility through processing of new applications, member additions and deletions, policy revisions, demographic changes, renewal changes and any other maintenance affecting eligibility - all in service of making our members' health journeys easier.
Do you have a passion for serving others and learning new things? Then this role may be the perfect fit.
What You Bring to Cambia :
Qualifications :
The Membership Eligibility Processor I would have a high school diploma or GED and six months data entry experience with demonstrated ability to meet or exceed accuracy and production standards.
The Membership Eligibility Processor II would have a high school diploma or GED and one year of experience as a Membership Eligibility Processor I with demonstrated ability to meet or exceed accuracy and production standards or an equivalent combination of education and job-related work experience.
Skills and Attributes :
40 wpm keying.
10-key by touch.
Must be detail-oriented and self-motivated.
Must be dependable and maintain attendance at or above departmental standards.
Must be able to exercise judgment, initiative and discretion in confidential, mature and sensitive manner.
Must be able to establish effective working relationships with staff and customers.
Ability to understand mathematical calculations and concepts.
Ability to organize and prioritize work.
PC experience required, experience with Word, Excel, and Outlook or similar software.
Ability to communicate effectively.
Medical Terminology for WSHIP health questionnaire processors required.
What You Will Do at Cambia :
Review, enter, and maintain changes on individual, small, large, trust or specialized group enrollment applications. Review and apply eligibility rules by calculating appropriate waiting period credit, eligibility data, effective date and enter benefits, name, social security number, address, family members and primary care physician information with network coding, which is consistent with contract.
Identify and prioritize work in order to meet deadlines including state requirements for timeliness.
Incorporate and apply changes made to Membership Accounting, Underwriting and State and Federal policies and procedures to ensure current requirements are met.
Responsible for meeting established departmental performance expectations.
Handle responses to inquiries to meet BlueCross and BlueShield Association (BCBSA) standards and corporate goals.
Provide customer service to internal customers and may place and track outgoing calls to external customers including groups, agents and subscribers to obtain information necessary for enrollment, while maintaining member confidentiality in all aspects of eligibility and billing processes.
Assist less experienced staff with questions and / or difficult issues or accounts as needed.
Maintain manuals to ensure policies and procedures are current.
Attend and participate in training and staff meetings.
LI-Remote
Last updated : 2024-05-31
Salary : $17 - $27
