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