Accidental Death and Dismemberment (AD&D), Analysis Skills, Auditing, Billing, Centers for Medicare and Medicaid Services (CMS), Communication Skills, Customer Support/Service, Data Processing, Detail Oriented, Healthcare, High School Diploma, Hospital, Identify Issues, Insurance, Leadership, Life Insurance, Maintain Compliance, Manual Dexterity, Medicare, Microsoft Access Database, Microsoft Excel, Microsoft Office, Microsoft Word, Office Equipment, Operational Support, Patient Confidentiality, Problem Solving Skills, Proofreading, Regulations, Retirement Plan, Software Administration
Billing and Membership Analyst
SummaCare - 1200 E Market St, Akron, OH
Full-Time/ 40 Hours / Days
Hybrid
Based in Akron, Ohio, SummaCare 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 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). 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.
Minimum Qualifications:
Formal Education Required:
- High school diploma or equivalent
- One (1) year experience in eligibility processing, auditing of records and reports, moderately complex data processing and/or working knowledge of customer service/claims/eligibility software applications that support healthcare operations.
Other Skills, Competencies and Qualifications:
- Microsoft Office: Access, Word and Excel at a basic level.
- Ability to type 35 words per minute at a 95% accuracy rate.
- Ability to communicate in a professional manner to a wide variety of audiences, including Senior Leadership. Excellent proofreading skills.
- Strong analytical skills to review data from a variety of sources in order to make recommendations/conclusions based on the outcomes.
- Excellent attention to detail and strong troubleshooting skills.
- Organize and manage time to accurately complete tasks within defined timeframes in a fast-paced, often-changing environment.
- Maintain current knowledge of and comply with regulatory and business information.
- Maintain confidentiality of member health and business information.
- Independent judgement, decision making and problem solving.
Level of Physical Demands:
- Sit for prolonged periods of time.
- Bend, stoop and stretch.
- Manual dexterity to operate computer, phone and standard office machines.
Equal Opportunity Employer/Veterans/Disabled
$19.54/hr - $23.45/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.
- Basic Life and Accidental Death & Dismemberment (AD&D)
- Supplemental Life and AD&D
- Dependent Life Insurance
- Short-Term and Long-Term Disability
- Accident Insurance, Hospital Indemnity, and Critical Illness
- Retirement Savings Plan
- Flexible Spending Accounts - Healthcare and Dependent Care
- Employee Assistance Program (EAP)
- Identity Theft Protection
- Pet Insurance
- Education Assistance
- Daily Pay