Enrollment & Billing Representative

Blue Cross of Idaho is seeking an Enrollment & Billing Representative (EBR) for our Meridian location. EBRs are responsible for enrollment and billing activities for our membership, by establishing and maintaining enrollment and accounts receivable records for group accounts. They also communicate with group representatives, members and applicants regarding enrollment and billing inquiries.

This is an onsite position at our Meridian, Idaho location, supporting our Commercial line of business team. At this time, relocation assistance is not offered with this opportunity.

Preferred Education: high school diploma or equivalency, degree, and/or industry-related certification(s).

Preferred Experience: 1/+ years in health industry/health insurance, general office, basic accounting, complex call center, or related experience is strongly preferred. Useful skills and abilities in the role include:

• Digital literacy, such as Microsoft Office Suite, data entry and typing, using multiple software applications, general computer skills, and intranet/internet navigation. Preferred experience using Facets and other Blue Cross of Idaho specific software programs
• Proofreading, accurately translate and code enrollment forms for entry/processing
• Problem-solving, following established workflows, and assessing workflows per regulations
• Communication and coordination with internal and external departments
• Knowledge of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), and/or the Employee Retirement Income Security Act of 1974 (ERISA) is helpful

We are looking for the following:

• Prior experience preferred in medical coding or billing
• Strong understanding of commercial group enrollment processes
• Knowledge of group billing structures (composite vs. tiered rates, retro adjustments
• Experience managing employer-sponsored health plans and eligibility rule
• Familiarity with premium billing, payments, and delinquency processes
• Strong attention to detail when auditing eligibility files and billing report
• Proficiency in Excel (v-lookups, pivot tables, basic analysis
• Experience with enrollment/billing systems or CRM tools (Salesforce, Facets)
• Ability to manage high-volume workloads
• Preferred knowledge of COBRA, ACA, and compliance requirements
• Organizational skills to manage multiple group accounts simultaneously
• Adaptability in a fast-paced, deadline-driven environment

Your day may look like:

• Process membership activity by establishing records, changing, coding and entering data. Review applications for completeness and maintain proper administration of underwriting regulations on eligibility and acceptance of premiums.
• Assure prompt, complete and accurate reconciliation of daily income by researching and adjusting membership records and reconciling paid bills/coupons. Send correspondence and collect premiums on delinquent accounts. Maintain eligibility and billing on the Facets system.
• Receive, research and reply to telephone, written and electronic inquiries related to enrollment and billing, within corporate and departmental guidelines. Correspond with members, as required (usually email or phone). Research enrollment requests for completeness timelines and applicable regulations.
• Performs quality checks on enrollment processing transactions, providing input and updates to workflows, training programs and quality assurance tools, as required. Assures all documents are properly coded and prepared for the Image/Archive System.
• Maintain knowledge of federal regulations including, but not limited to the following: HIPAA, COBRA and ERISA. Complies with all local, state and federal regulations.

As of the date of this posting, a good faith estimate of the current pay range is: $19.45 - $27.23. The position is eligible for an annual incentive bonus (variable depending on company and employee performance).

The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program.

We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Reasonable accommodations

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.