Supervisor Membership Accounting

Let’s do great things, together

About Moda
Founded in Oregon in 1955, 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. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Position Summary
Manage the day-to-day operational activities of the Moda and BHS Membership Accounting Department covering a wide range of responsibilities to ensure retention of existing groups, members, regulators, and partners and improve efficiency of all administrative services. Core management responsibilities include: Coaching, Supervision, Development, Motivation, Direction and Support to Membership Accounting Specialists. Measures and evaluates results to determine if standards are being met. This is a full-time hybrid position based in Portland, Oregon.

Pay Range
$63,115.35 - $78,912.19 annually

• Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page, linked below, to be considered for this position

• https://j.brt.mv/jb.do?reqGK=27746778&refresh=true

Benefits:

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

Required Skills, Experience, & Education:

• College degree or four years relevant industry experience preferred
• Knowledge of either; COBRA, Retirement plans, Medicare, Medicaid, Commercial Group, Individual, Affordable Care Act, Private Exchanges, or TPA business.
• 4 years’ experience with Membership Accounting (enrollment, billing, reconciliation) preferred
• Strong analytical, problem solving, decision-making, and organizational skills.
• Ability to deal effectively with a variety of individuals, government organizations, agents and groups related to the provision of services designed to retain existing accounts and obtain new accounts.
• Ability to communicate effectively, both verbally and in writing. Ability to conduct meetings and presentations with internal as well as external customers and constituents.
• Ability to achieve extraordinary results through effective management of resources, systems, and processes.
• Demonstrate strong, effective, and diplomatic interpersonal communication skills with employees of all levels.
• Ability to work well under pressure, work with frequent interruptions and shifting priorities
• Ability to hire, lead, motivate, and develop staff.
• Ability to adapt to change, work independently and as part of a successful team.
• Maintain attendance above company standards.
• Ability to maintain confidentiality and project a professional business image.
• Computer proficiency with Microsoft Office applications.

Primary Functions:

• Responsible for daily operation of billing, eligibility, and reconciliation functions in one of; Medicare, Medicaid, Commercial Group, Individual, or BHS.
• Supervises and develops staff, develops goals, provides daily work direction, vacation scheduling, monitoring work and attendance, and hiring and terminating employees.
• Ensures that appropriate personnel policies and procedures are followed using coaching, counseling, performance evaluations, promotions, and demotions, as needed.
• Oversees training of new and existing staff on all billing and eligibility functions, on all product lines, and ensures that staff have the necessary tools and resources to be successful.
• Assists staff with resolution of problem accounts involving eligibility, billing, and reconciliation.
• Maintain an understanding on administering eligibility, billing and reconciliation procedures and guidelines as they pertain to your product line(s); Medicare, Medicaid, ACA (Exchange), Employer Group, Retiree Administration, COBRA, etc.
• Assist in development and implementation of new systems and technology.
• Resolve complex problems and issues involving other departments, customers, state and federal regulators, agents/brokers, and constituents.
• Be an active, integral, dynamic, and contributing member of the Membership Accounting Leadership Team. There will be times when you and your team will help other Membership Accounting Teams.
• Ensure excellent customer relations with internal customers, external customers, state and federal regulators, and agents/brokers.
• Remain aware of developments in your line of business (Medicare, Medicaid, ACA, Employer Group, BHS, etc.) and assist with coordinating plan changes, open enrollment, and renewals.
• Responsible for and always promoting quality and continuous improvement within your department and within the Membership Accounting division.
• Keep Membership Accounting Manager and/or Director abreast of department activities and concerns.
• Ensure department quality assurance standards and turn-around times are adhered to through monitoring. Develops effective ways to measure turnaround time and monitor results.
• Analyzes staffing needs and makes recommendations to Membership Accounting Manager and Director as workload and efficiencies fluctuate.
• Develops and approves all department Policies and Procedures (UPM’s), works with Membership Accounting Leadership Team on division level Policies and Procedures.
• Responsible for quality and process improvement.
• Performs other duties as assigned.

• Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need.
• Work externally with Employers, Members, Government Agencies (CMS, etc.), TPA’s, Vendors, Group Administrators, Agents/Brokers, and all internal Moda and BHS Departments and Leadership