Account Specialist I

Position Description:

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”

Responsibilities and Qualifications:

Duties and Responsibilities

25% - Responsible for the creation of member eligibility within the Facets System for Individual Membership, which includes Blue Reliance, Security, On/Off exchange, Dental, Vision and CHIP. The enrollment of member information is completed according to all policies, procedures and mandates within a specified time frame. This also includes canceling contracts, processing name changes and setting up Check it out banking information

25% - Responsible for researching returned refund checks, completing fund transfers and processing refunds from daily reports. The payments are reconciled according to all policies and procedures within the specified time frame. Additional financial transactions may include transferring premium dollars, and completing refunds.

25% - Responds to telephone and/or written inquiries received from Customer Service, IA Account Executives and other internal units.

25% - Reviews, processes and researches various member reports and provides explanations as needed (i.e., Group Billing Error Report, Request Ad Hoc Reports, CL-M-150 +6 Prem Register Report, PREF Refund Report)

Experience:

• Must possess excellent keyboarding skills to operate a PC and other office equipment. (e.g., copy machine, fax machine, printer, calculator, etc.) Must be proficient in the use of PC software and end user computing tools. (e.g., Windows NT, Email, Instant Messenger, Microsoft Excel and Microsoft Word). Must be familiar with logging into various Computer applications and databases.
• Familiar with basic mathematical concepts used in the calculation of subscriber premium refunds and invoicing.
• Knowledge of billing and enrollment policies and procedures and government regulations associated with Individual Account Subscribers
• Must be familiar with Work desk (Image) and workflow.
• Ability to effectively communicate verbally and in writing.
• Ability to work independently to perform duties with minimal supervision.
• Must have the ability to adapt to constant changing priorities and keeping daily responsibilities on task.
• Must be willing and able to work overtime during peak periods, which typically fall between November and February.
• Performs other related duties and assignments as directed.

Education and Certifications:

• Must possess a high school diploma or G.E.D.

About Us: We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.