Sr Billing and Membership Analyst

Sr. Billing & Membership AnalystSummaCare - 1200 E Market St, Akron, OHPer Diem (PRN) / Variable ScheduleSummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4 out of 5-Star rating. SummaCare has also been recognized by U.S. News & World Report as being a Best Insurance Company for 2022 Medicare Advantage Plans. Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.Summary:Develops, implements, performs and reconciles transactions in our claims system and surrounding vendor systems while ensuring all regulatory compliance guidelines are followed and met. Researches and maintains knowledge of current and proposed legislation impacting enrollment, eligibility and premium billing functions, to ensure department compliance. Creates and maintains instructional materials, reports, policies and procedures and legal and/or technical documents. Mentors new team members through onboarding, training and ongoing support as needed.Formal Education Required:a. Associate degree or equivalent combination of education and/or experience.Experience & Training Required:a. Two (2) years'' experience in eligibility processing, auditing of records and reports, complex data processing and/or working knowledge of claims/eligibility software applications that support healthcare operations.3. Other Skills, Competencies and Qualifications:a. Microsoft Office: Access, Word and Excel at an intermediate level.b. Ability to type 40 words per minute at a 95% accuracy rate.c. Ability to communicate in a professional manner to a wide variety of audiences, including Senior Leadership. This includes presentations, correspondence, instructional materials, reports, policies and procedures and legal and/or technical documents. Excellent proofreading skills.d. Strong analytical skills to review data from a variety of sources in order to make recommendations/conclusions based on the outcomes.e. Excellent attention to detail and strong troubleshooting skills.f. Organize and manage time to accurately complete tasks within defined timeframes in a fast-paced, often-changing environment.g. Maintain current knowledge of and comply with regulatory and business information.h. Maintain confidentiality of member health and business information.i. Independent judgement, decision making and problem solving.4. Level of Physical Demands:a. Sit for prolonged periods of time.b. Bend, stoop and stretch.c. Manual dexterity to operate computer, phone and standard office machines.

Created: 2026-03-07