Billing Membership Analyst - 3053699

Job#: 3053699

Job Description:

Location: Akron Ohio, Fully Onsite Monday - Friday

3 Month Contract

$17-19/HR

This role is responsible for managing and maintaining member eligibility, enrollment, premium billing, and claims-related transactions within healthcare systems while ensuring compliance with federal, state, and regulatory requirements. The position serves as a critical link between members, providers, employer groups, brokers, and internal operational teams to ensure accurate enrollment records, billing information, and healthcare coverage data.

Core Responsibilities

Eligibility & Enrollment Administration

• Process, implement, and maintain member and group enrollment records in healthcare claims and eligibility systems.
• Ensure timely and accurate setup of new members, employer groups, and coverage updates.
• Review enrollment files, validate data accuracy, and resolve system-generated errors.
• Reconcile enrollment and billing data between internal systems and third-party vendors.

Compliance & Regulatory Oversight

• Maintain knowledge of healthcare regulations impacting enrollment, eligibility, and premium billing.
• Investigate and resolve transactions rejected by CMS, Health Insurance Marketplace systems, and other regulatory entities.
• Monitor operational processes for compliance risks and take corrective action when deficiencies are identified.
• Assist in developing and maintaining policies, procedures, and workflows that support regulatory compliance.

Data Analysis & Quality Assurance

• Analyze enrollment, eligibility, and billing data to identify inconsistencies, trends, and operational issues.
• Conduct audits and quality reviews of files exchanged with external vendors and partners.
• Research discrepancies and recommend solutions to improve accuracy and efficiency.
• Perform data reconciliation activities to ensure system integrity and compliance.

Customer Service & Stakeholder Support

• Provide support to members, providers, employers, brokers, and internal teams regarding:
• Eligibility and enrollment status
• Premium billing inquiries
• Coordination of benefits
• Primary care provider assignments
• Address and demographic updates
• Respond to inquiries received through phone, email, portals, and workflow management systems.
• Document client interactions and ensure requests are routed to the appropriate departments for resolution.

Operational Support

• Manage inbound support requests and maintain accurate records within document management systems.
• Process, organize, and batch correspondence for electronic storage.
• Work independently on assigned tasks while collaborating with cross-functional teams to meet departmental objectives.
• Support continuous improvement initiatives focused on operational accuracy and customer satisfaction.

Key Qualifications

Experience

• 1+ year of experience in one or more of the following:
• Healthcare enrollment or eligibility processing
• Claims administration
• Healthcare operations support
• Data auditing and reconciliation
• Customer service within a healthcare environment

Technical Skills

• Basic proficiency with Microsoft Excel, Word, and Access.
• Experience working with claims, enrollment, eligibility, billing, or healthcare administration systems.
• Ability to type at least 35 WPM with high accuracy.

Critical Competencies

Strong analytical and problem-so