Medicaid Senior Enrollment Specialist
New
H
HealthEdgeHealthcare Technology
Remote, US, Work across multiple time zonesFull-TimeSenior
Salary50,000 - 56,000 USD per year
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Job Details
- Experience
- 5+ years of professional experience in processing Medicare enrollment transactions
- Required Skills
- Data Analysis
Requirements
- 5+ years of professional experience in processing Medicare enrollment transactions.
- Thorough understanding of Medicare Advantage products.
- Expertise with CMS transaction files and enrollment-related guidelines.
- Experience with CMS interfaces and systems for Medicare Advantage enrollment and billing.
- Ability to analyze enrollment reconciliation data and report on SLAs and KPIs.
- High school degree required.
- Willingness to learn.
- Team collaborator.
- Strong work ethic.
- Ability to adapt to a challenging environment.
- Self-starter and quick learner.
Responsibilities
- Prepare, process, and maintain enrollment and disenrollment requests.
- Verify and maintain all applicable eligibility requirements.
- Review and process CMS transactions.
- Review Medicaid eligibility and complete verification processes.
- Resolve enrollment system rejections based on regulatory and client guidelines.
- Reconcile membership reports as required by CMS.
- Attend and successfully complete scheduled trainings.
- Mentor junior members of the team.
- Collaborate on special projects, including process documentation and quality reviews.
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