Individual Account Specialist
PacificSource Health Plans - Boise, ID

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Handle customer inquiries regarding their account and update records accordingly. Reinstate members, terminate members, and work reports regarding payment and account status. Process payments daily. Reconcile and audit accounts receivable and billing data. Set up and process credit card payments. Monitor past due payments and generate letters.

Provide customer service to external customers via the Individual phone queue, e-mail, and on-site visits from customers.
Process electronic/lockbox deposits daily. Prepare manual deposits to be sent to lockbox for processing. Process manual deposits as needed.
Process credit card payments on a daily and monthly basis.
Reconcile monthly credit card payment upload file to report. Manually post non-recurring credit card payments and request reversals on all declined and expired transactions.
Update member information based on documentation received or when coverage is changed.
Complete reinstatements on a monthly basis for members termed for non-payment of premiums.
Administer eligibility, billing, and payments files for members enrolled in Family Health Insurance Assistance Program. Reconcile on a monthly basis.
Complete cash transfer forms to transfer premium dollars on an as-needed basis.
Log refund check requests as needed for processing by Finance and Membership Eligibility & Billing Analysts.
Generate ID cards and various letters as needed, according to state laws.
Monitor report of Individual members with past due balances. Generate letters requesting payment due to insufficient funds or credit card expiration and declinations.
Set up and maintain credit card information in system. Assure all activations, terminations, and change requests meet compliance standards as defined by Finance. Generate letters and monitor account balances of credit card members.
Set up and maintain Electronic Fund Transfer (EFT) records in system. Audit file of electronic funds transfer transactions for Individual members. Assure all activations, terminations, and change requests meet compliance standards as defined by Finance. Generate letters and monitor account balances of EFT members.
Suspend delinquency on members whose payment is received in regional offices on last day of month, to prevent auto-termination, utilizing the Universal Check Log. Monitor report of members with suspended billing or delinquency indicator weekly.
Audit various reports as needed in regard to termed Individual members with balances, or those that auto-term and apply reinstatement, collection, write off, or refund guidelines as needed.
Process member terminations upon written request.
Work with the Individual Sales Department to ensure hand-offs between the departments are efficient and timely.
Update Individual demographic information from mail, telephone or email notifications.

Supporting Responsibilities:
Participate in LEAN Board daily review, team and department meetings, mentor training, and team building activities.
Support Team goals and responsibilities, regardless of state location and varying state rules and guidelines.
Participate in various committees and inter-office meetings as scheduled.
Provide support to the Membership Department as needed.
Meet or exceed accuracy standards and PRISM measures as required.
Meet department and company performance and attendance expectations.
Assist with policy and procedure updates as requested.
Perform other duties as assigned.

Work Experience: Minimum of one year prior Accounting/Accounts Receivable experience with strong keyboarding and 10-key experience required. Experience with Excel strongly preferred.

Education, Certificates, Licenses: High school diploma or equivalent required.

Knowledge: Ability to understand and interpret Federal, Oregon, Montana and Idaho State laws and PacificSource contract provisions. Excellent verbal, telephone and written communication skills. Strong customer service skills required. Ability to adhere to company and department policies and meet expectations for service, accuracy and efficiency.

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 customer service.
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, and the pursuit of excellence.

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% 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 is an equal opportunity and affirmative action employer.

PacificSource Health Plans - 21 months ago - save job - block
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About this company
4 reviews
PacificSource Health Plans is anything but a typical health plan. We’re a growing, independent, not-for-profit organization with a...