Let’s do great things, together

Founded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

The Membership Accounting Specialist II is responsible for accurate and timely data entry and maintenance of member enrollment, eligibility, premium billing, and payment reconciliation for assigned Moda Health and its subsidiaries groups. Assist Membership Accounting Specialist I in problem solving and problem resolution. Provide on-going technical, soft skill, coaching and support for the unit.

This is a full-time remote position for candidates living or willing to relocate to the following States ONLY: AK, AZ, FL, ID, OR, TX, or WA.

Please follow the link below to apply to this position:

• https://j.brt.mv/ATS/jb.do?reqGK=27702328&refresh=true

Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

• PST

• High school diploma/ GED.
• 1-year experience as MA specialist I preferred or relevant work experience consistently exceeding requirements.
• Proficiency in Facets systems along with knowledge of all other eligibility and reconciliation procedures and enrollment rules.
• Proficiency with Microsoft Office including Excel and PC applications which includes the ability to navigate multiple programs and learn new and complex computer system applications.
• Ten key proficiency of 135 kpm on a computer numeric keypad/calculator preferred.
• Typing proficiency of 35 wpm preferred.
• Evidence of ability to develop, direct, motivate, and gain commitment with teams.
• Strong analytical, problem solving, decision making, organizational and detail-oriented skills.
• Strong verbal, written and interpersonal communication skills.
• Highly motivated to identify and solve problems.
• Ability to manage a wide variety of tasks.
• Maintain confidentiality and project a professional business image.
• Maintain a HIPAA compliant workstation and utilize appropriate security techniques to ensure protection of all confidential and protected client and enrollee data.

• Responsible for successful implementation of new and renewing group business in BHS COBRAPoint as assigned.
• Manage member eligibility, enrollments premium billing and payment reconciliation for assigned Moda Health and subsidiaries’ high profile, complex and strategic groups.
• Assume responsibility and ownership of project work as assigned.
• Interact with customers to gather support data to ensure invoice accuracy and resolve billing discrepancies.
• Update systems and policies using defined methods and procedures for effective management and control of the premium billing function.
• Reconcile monthly billing and eligibility and ensure correct administrative fees and premium are reflected in Facets.
• Process delinquent accounts.
• Process claims pay holds, rating overrides, discretionary billing items, refunds, cash transfers and write offs as needed.
• Educate internal and external clients on processes and procedures pertaining to billing and eligibility and their specific contract.
• Perform audits of eligibility and reconciliation data.
• Respond to all internal and external customer inquiries in a clear and professional manner via phone, or in-person meeting.
• Provide mentorship and support to junior colleagues.
• Be a supportive and collaborative teammate.
• Perform other duties and projects as assigned within specified turnaround times.
• Process tasks and responsibilities within department meeting threshold auditing stats at Exceeding requirements.
• Manage sensitive and vital groups successfully.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.