Membership Administrator I-III, DOE

Membership Administrator I-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 Membership Administrators is living our mission to make health care easier and lives better. As a member of the Membership team, our Membership Administrators establish and maintain eligibility, bill premiums, reconcile discrepancies, pursue aged accounts, and provide customer service for Individual, Group, Government Programs, COBRA, and Flexible Spending business – all in service of creating an economically sustainable health care system.  

Do you have a keen eye for detail and a knack for resolving discrepancies? Do you enjoy supporting customers with clarity and care across a variety of complex billing and eligibility needs? Then this role may be the perfect fit. 

What You Bring to Cambia: 

Qualifications:  

• High School diploma or GED

• 1 year of accounts receivable or customer billing experience

• Equivalent combination of education and related work experience 

Additional Qualifications for Level II:

• 40 wpm with 95% accuracy typing skills.

• Demonstrated strong math skills (mathematical calculations and concepts) and judgment to implement effective problem solving.

Additional Qualifications for Level III:

• 50 wpm with 95% accuracy typing skills.

• Must be able to work independently with minimal direction and supervision.

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

Skills and Attributes: 

• Typing at 30 WPM with 95% accuracy; 10-key by touch preferred (8,500 keystrokes/hour)

• Proficiency in Microsoft Word, Excel, and Outlook or comparable software

• Strong math skills with the ability to perform calculations and solve problems effectively

• Experience with AI tools to enhance productivity and decision-making is highly desired

• Ability to coordinate, prioritize, and manage work independently with a self-motivated approach

• Strong written and verbal communication skills

• Ability to build effective working relationships while exercising sound judgment and discretion

What You Will Do at Cambia:  

• Process and maintain enrollment applications, including eligibility data, effective dates, benefits, and member information in accordance with employer/individual contracts

• Review accounts for completeness, identify missing information, and coordinate with employers, agents, and carriers to complete processing

• Generate, review, and reconcile individual and group billings, ensuring accuracy and timely cash processing in line with corporate standards

• Provide customer service to internal and external customers through written correspondence and phone, making necessary corrections as needed

• Monitor and pursue aged accounts, apply underwriting and governmental guidelines, and ensure compliance with federal, state, BCBSA, and accreditation regulations

• Order and audit member cards, research documentation, and coordinate electronic data transfers with outside entities such as CMS, employer groups, and vendors

• Support team operations through training participation, testing assistance, clerical tasks, and staff backup as needed 

Additional Responsibilities for Level II:

• Accurately and timely perform all eligibility and reconciliation tasks for assigned business segment, following established procedures and identifying discrepancies between payments and invoiced amounts.

• Assist with coaching, mentoring, and training as directed by Supervisor; serve as a resource for team questions.

• Model ethical behavior and professionalism in all internal and external interactions.

• Deliver professional presentations and training for diverse audiences, including employer groups and agents.

• Conduct thorough research and apply sound decision-making skills to resolve complex problems.

• Participate in quality initiatives, task forces, work groups, and process improvement teams.

• Maintain up-to-date manuals and procedures, incorporating changes from Membership Accounting, Underwriting, and State and Federal policies to ensure compliance.

• Stay current on applicable State and Federal regulations (Government Programs roles).

• Develop test cases and support user acceptance and system integration testing.

Additional Responsibilities for Level III:

• Assist with coaching, mentoring, and training as directed by Supervisor; serve as a resource for staff at all levels.

• Support the Member Services Lead or Supervisor as appropriate.

• Complete Requests for Proposals (RFPs) to support acquisition, account management, and retention efforts.

• Assist in training membership staff and answer questions as needed.

• Help resolve complex eligibility and reconciliation issues.

• Represent the Membership division in internal and external meetings, including facilitation as needed.

• Audit, research, and perform reconciliation tasks for alternative and/or self-funded accounts to ensure accurate and timely earnings and statistical reporting.

• Create and maintain up-to-date policy and procedure manuals.

• Incorporate and apply changes from Membership Accounting, Underwriting, and State and Federal policies to ensure ongoing compliance (Government Programs roles).

• Research and respond to state insurance commission inquiries (Government Programs roles).

• Coordinate and develop test cases; support user acceptance and system integration testing.

#LI-Remote

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.

Membership Administrator I:

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $18.25 - $23.00 an hour, the full salary range is $18.25 - $27.20 an hour, and the bonus target is 5%.

Membership Administrator II:

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $20.40 - $24.85 an hour, the full salary range is $18.25 - $29.40 an hour, and the bonus target is 5%.

Membership Administrator III:

• Oregon, Washington, Utah, and Idaho: The expected hiring range is $23.00 - $29.50 an hour, the full salary range is $19.20 - $34.90 an hour, and the bonus target is 5%.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care.  Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can:  

• Work alongside diverse teams building cutting-edge solutions to transform health care.  
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.  
• Grow your career with a company committed to helping you succeed. 
• Give back to your community by participating in Cambia-supported outreach programs.  
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.  

We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.  

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: 

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. 
• Annual employer contribution to a health savings account.  
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. 
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). 
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). 
• Award-winning wellness programs that reward you for participation. 
• Employee Assistance Fund for those in need. 
• Commute and parking benefits. 

Learn more about our benefits. 

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.