Membership Rep I - PSA

Company Name:
PacificSource Health Plans
Maintain enrolled Flexible Spending Accounts (FSA), Health Reimbursement Arrangements (HRA) and Transportation (TRN) plans and COBRA for groups and members. Provide customer support to group administrators, agents, carriers and PacificSource staff. This includes plan, administration, regulatory compliance and billing assistance.
Essential Responsibilities:
1. Process group forms and notices for FSA/HRA/TRN and COBRA using group plan documents and other guidelines. Research and resolve any questions or missing information by contacting group administrators. Group forms include: Enrollment Forms for current and retroactive elections, Change Forms for demographic and election changes and Termination Notices and related Qualified Beneficiary forms.
2. Process and balance daily payments. Review invoices and record adjustments as applicable.
3. Review and follow-up with group administrators and agents on unpaid and past due invoices.
4. Review carrier billings and other correspondence as required ensuring enrollment information matches the carrier records. Communicate any discrepancies with the carrier until resolved. This includes, but is not limited to, enrollment dates, termination dates, and premium rates.
5. Process Benefit Plan Renewals to include updating new plan rates and types.
6. Prepare administrative fee invoices as directed.
7. Assist group administrators, agents, and PacificSource staff on eligibility requirements, IRS regulations, and calculation of group elections and fee balances, as well as COBRA premium rates.
8. Provide customer support via phone and e-mail to group administrators, agents, carriers and PacificSource staff.
9. Support web-based changes submitted by group administrators.
10. Enter and maintain information in multiple databases such as ACT!, PayDirect, QuickBooks, TRAVIS or other COBRA related software platform(s). This will include but not limited to; setting up new groups, updating existing groups at renewal and making any needed mid-year plan changes.
Supporting Responsibilities:
1. Continuous contact with department staff and frequent contact with other personnel. Daily contact with external customers.
2. Participate in department meetings and training; take advantage of opportunities to increase knowledge and skills.
3. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
4. Meet department and company performance and attendance expectations.
5. Perform other duties as assigned.
Work Experience: Minimum of one year of basic accounting or financial transactions experience required.
Education, Certificates, Licenses: High school diploma or GED required.
Knowledge: Basic accounting skills/experience required. Ability to prioritize work and meet department metrics and timelines. Advanced computer skills, ability to type using a standard keyboard and operate a 10-key pad by touch.
Our Values
Building Customer Loyalty
Building Strategic Work Relationships
Continuous Improvement
Building Trust
Work Standards
Contributing to Team Success
Planning and Organizing
We are committed to doing the right thing.
We are one team working toward a common goal.
We are each responsible for our customer's
We practice open communication at all levels of the company to foster individual, team and company growth.
We actively participate in efforts to improve our many communities-internally and externally.
We encourage creativity, innovation, continuous
improvement, and the pursuit of excellence.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 2% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource Health Plans is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, age.
Date: 2014-07-30
Country: US
State: OR
City: Springfield
Postal Code: 97477
Job Type: Regular Full-Time

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