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Position Description

Arkansas Blue Cross and Blue Shield - NON-EXEMPT POSITION DESCRIPTION

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Position:  Membership Clerk - 5
Reports To: 
Division:  Blue Advantage Membership (2800)
Company:  ABCBS
Location:  Label
Job Code:  63310B
Min Salary:   24100
Date Posted:  5/3/2013

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Position Specific Requirements: No position specific requirements


Job Summary
The Membership Clerk is responsible for accurate and timely processing of incoming mail, enrollment packets, Member Identification (ID) Cards, premium checks, and file maintenance for group and member records.  The incumbent provides clerical support for Membership Processors, Membership Specialists, Division Secretary, Supervisors and Manager.  The Membership Clerk is subject to all Enterprise and divisional standards of quality and performance.  

Nature & Scope
•ENVIRONMENT

The environment is one of teamwork in which all team members work together in order to provide excellent service through timely processing of incoming mail, distribution of member ID cards and benefit materials, and file maintenance.   Outside issues affecting this division and position include peak seasons, systems down time, inclement weather, holidays and absenteeism.  All directly affect the volume of work for each Membership Clerk.  

•WORKFLOW

The Group Enrollment Information (GEI)/Group Master form is received from Membership Specialist.  Paper adds/changes and monthly premium are received from Employer Groups on a daily basis through incoming mail.  Once subscribers and members are entered, ID cards are verified and mailed with benefit materials to the subscriber’s home.  For ABCBS and Health Advantage, premium checks are received through incoming mail.

•GUIDANCE

Corporate and division policies, Group Contracts/ASO Agreements and Evidence of Coverage/Certificate of Coverage/Plan Documents, legislative changes, and strict accounting standards guide the activities of the Membership Clerk.  Training is received on the job and through Enterprise offerings and division in-service training.  The Membership Clerk receives direction from Membership Specialists, Division Secretary, Supervisors and Manager.  


•CHALLENGES

Continually changing group requirements, legislative changes, and tight time constraints during peak periods represent the most difficult challenges for this position.  The Membership Clerk must have ability to learn Membership systems.  The Membership Clerk is challenged to meet all internal and external (MTM and Rule and Regulation 43) enrollment and accounting accuracy and timeliness standards and performance guarantees included in the group contracts.  

•INTERFACES

This position interfaces regularly with Membership Processors, Membership Specialists, Division Secretary, Supervisors and Manager, and occasionally with Customer Service, IS and Claims.  

•AUTHORITY

This position has the authority to contact Customer Service and Claims.  This position has the authority to recommend and implement changes to improve efficiency and quality of service to internal and external customers.

Minimum Job Requirements
1. Pass company proficiency test for reading, typing, math and alphabetical order
2. High school diploma
3. Office experience within the last 5 years (preferred)

Security Requirements
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

PRINCIPAL ACTIVITIES OR ACCOUNTABILITIES (Essential Functions of Job)
The Group Enrollment Information (GEI)/Group Master form is received from Membership Specialist.  Paper adds/changes and monthly premium are received from Employer Groups on a daily basis through incoming mail.  Once subscribers and members are entered, ID cards are verified and mailed with benefit materials to the subscriber’s home.  For ABCBS and Health Advantage, premium checks are received through incoming mail.
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