Membership Representative Lead

  • Monitors the unit’s schedule for sufficient coverage. Reviews aging of forms, while continually re-prioritizing based on departmental needs.
  • Participates in the establishment and review of departmental goals and implements procedures and performance standards. Ensures goals are communicated to staff.
  • Prepares reports and documentation concerning departmental activities. Reviews weekly auditing reports.
  • Monitors processing, tracks and delegates work based on departmental goals, backlogs and ensures equitable distribution.
  • Reviews weekly auditing reports for accuracy and maintains accuracy and production tracking logs.
  • Works with staff to reconcile audit discrepancies and resolve eligibility questions. Reviews/analyzes returned audit tickets. Identifies training/performance gaps.
  • Ensures action plans are in place to reduce backlog and effect resolution to ongoing issues.
  • Mentors and trains new associates. Advises and/or counsels staff members on correct procedures.
  • Responds to phone calls from other service centers and internal units.
  • Encourages associates in the units to assist other units as necessary.


  • Associate’s Degree in Business or Health Care or related experience is preferred.
  • Four years membership accounting or related experience.
  • Previous experience with vendor oversight/leading a team strongly preferred
  • Intermediate Excel skills strongly preferred
  • Knowledge of medical insurance and/or medical terminology strongly preferred
  • Healthcare or healthcare insurance experience preferred