Membership Representative I
Core
Enrolling members, managing billing activities, and maintaining assigned accounts for health plan members, providers, and employer groups.
Role type
Entry-level membership and enrollment representative
Builds
Enrollment records and billing processes for health insurance plans
Domain
Health insurance / Member services
Deliverable
client delivery
Required skills
Enrollment verification, billing reconciliation, eligibility determination, data entry, customer service, error resolution, contract interpretation
Preferred skills
Membership experience, customer service background
Technologies
Enrollment systems, billing platforms, digital tools
Responsibilities
Respond to incoming and outgoing calls to answer benefit questions and resolve issues; verify enrollment status and make record changes; process billing and delinquency for assigned groups; maintain enrollment database; determine eligibility and apply contract language; resolve error outputs for electronic eligibility; bill, collect premiums, and reconcile payments; screen forms and data for new group benefits; load rates to new or renewal groups.
Seniority
Entry-level, non-management