Moda Health Lead Membership Accounting, Medicare in Portland, Oregon

Lead Membership Accounting, Medicare

Job Title

Lead Membership Accounting, Medicare


Open Until Filled





Other Location


Let’s do great things, together 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. Currently, Moda Health is seeking a Lead in our Membership Accounting Specialist, Medicare Unit. This position will be responsible for coordinate and handle complex accounts and be a point of contact for external (CMS, FFM, CCO/DCO, Employer Groups, etc.) and internal constituents; provide back up for Supervisor and assists the Supervisor in monitoring unit performance relative to key objectives; provide on-going technical support and back up for all eligibility, billing and reconciliation for the unit; be a model of leadership, help guide and develop your team; identify, develop and conduct unit training needs on a primarily individual basis for all existing employees and backs up the trainer for all new employees.

Primary Functions:

  1. Identify, develop and conduct unit training needs primarily on an individual 1:1 basis.2. Assist Membership Accounting Specialists in problem solving and problem resolution. Provide on-going technical support to unit and acts as a liaison with other departments.3. Coordinate new group set-up for the more complex accounts, this includes but not limited to: verification of the group application, meeting with group administrators and participating in installation meetings with Sales, BIU, IT and Marketing personnel.4. Provide back up for supervisory duties and be a model of Leadership to your department while guiding and developing the Membership Accounting specialists. Could include assuming the role of interim supervisor for the unit.5. Provide back up to the Membership Accounting Trainer and all Membership Accounting Specialists in the unit.6. Assist in updating department policies and procedures.7. Administer quality control audits for established unit staff.8. Monitor unit performance relative to key objectives and turn around time.9. Handle special projects and assignments as determined by Management including the development of new programs and associated documentation.10. Perform other duties as assigned.

Are you ready to be a betterist? If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible. 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.

Required Skills

  1. High school diploma or equivalent.

  2. Computer proficiency with Microsoft Office applications.

  3. Typing proficiency of 35 wpm preferred.

  4. 10 key proficiency of 135 spm on a computer numeric keypad/calculator preferred.

  5. 12 months experience as a Membership Accounting Specialist, consistently exceeding all levels of performance or equivalent experience preferred.

  6. Familiarity with Moda and/or BHS enrollment, billing, reconciliation and other operational systems and workflows preferred.

  7. Ability to train others and present information in a well thought out and easily understood fashion.

  8. Strong verbal, written, and interpersonal communication skills and ability to interact professionally, patiently, and in a positive manner with internal and external customers.

  9. Ability to instruct, motivate and direct individuals at various skill levels, and various personality types, face to face an in the classroom environment.

  10. Strong analytical, problem solving, decision making, organizational, and detail orientated skills.

  11. Ability to work well under pressure and set priorities in a complex and rapidly changing environment.

  12. Maintain confidentiality and project a professional business image.

  13. Good to great leadership skills, previous leadership experience preferred.

  14. Ability to work with frequent interruptions and demonstrate professional leadership qualities. Self-motivated, requiring little to no guidance or direction.