Job Description

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market-driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.

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.”

The Group Account Specialist is responsible for the set up and maintenance of the large and small groups in Facets. This includes the entry of group and member enrollment, changes and terminations which directly impacts ID cards, claims processing, customer service, members and MTM ratings. Additionally, this position is responsible for group financial analysis. The Group Account Specialist works closely with internal and external customers through telephone and written contact. The incumbent works independently and as a team player representing the unit. The incumbent will be required to attend a 6 - 8 week training class as well as ongoing periodic refresher training.

Responsibilities and Qualifications

• Responsible for accurately entering all group and member enrollment activity into Facets and/or eGEMS. This activity is completed according to all policies and procedures within the specified time frame. Includes group and member new enrollments, terminations, product changes, etc.
• Responds to phone and written inquiries received from Internal and External Customers. Accountable for making adjustments and corrections to group information as necessary. Educates customers on various policies and procedures related to group and member enrollment.
• Reviews, researches and corrects enrollment for various error reports (i.e., Group Billing Error Report, MSP Reports, etc.). Responsible for analyzing group payments received on Facets. These payments are reconciled according to all policies and procedures within the specified time frame. This includes verifying invoices, transferring/refunding money, and documenting information to ensure the correct amount was paid.

Leadership:

• Ability to perform duties with minimal supervision. Includes the ability to act both independently and as part of a team while adapting to changing priorities.

Skills:

• Ability to communicate effectively and professionally, both verbally and in writing with various audiences. Ability to plan, organize and coordinate multiple tasks and priorities. Must have proficient typing skills in order to maintain productivity levels.

Knowledge:

• Knowledge of government regulations, Account Administration and various department policies and procedures as they relate to large and small group business (i.e., MSP regulations, COBRA, overage policies of groups, ID cards, HIPAA/conversion information, etc.).
• Proficiency in the use of PC software and end user computing tools (Outlook, Word, Internet Explorer, Excel and Power Point). Must be familiar with work desk (Image) and workflow. Ability to analyze data and reconcile group and member invoices.

Experience:

• A minimum of 1 year experience working in a data entry environment, preferably enrollment and billing.
• Experience with customer interaction preferred but not required.

Physical Demands:

• While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds.

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 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.