Enrollment Representative - 244920

Job Title: Enrollment RepresentativePosition Summary: The Enrollment Representative is responsible for accurately processing, reviewing, and updating enrollment applications for Medicare Advantage Plans in compliance with CMS guidelines and company policies. This role requires strong attention to detail, excellent communication skills, and the ability to meet high productivity and accuracy standards in a fast-paced environment.Responsibilities / Job DutiesAccurately, enter, review, and update enrollment applicationsVerify applicant eligibility for Medicare Advantage Plans, ensuring compliance with CMS guidelinesReview applications for completeness, required documents, and accuracy before submissionProcess plan changes, denials, and special election request as applicableMaintain up-to-date knowledge of CMS enrollment guidelines, HIPAA requirements, and company policiesIdentify, document, and escalate enrollment discrepancies or errors in accordance with compliance protocolsPerform qualify check on one's own work to meet accuracy metricsRespond to internal inquiries from agents, brokers, and customer service teams regarding enrollment statusProvide clear, professional communication to resolve application issues in a timely mannerCollaborate with internal departments to ensure prompt resolution of enrollment-related issuesConsistently meet or exceed productivity, accurate, and timeliness goals for enrollment processing (metrics = processing 80-110 applications, about 8-10/hour, they will ramp them to this)Track daily work volumes, turnaround times, and error rates in line with department performance standardsAccurately, enter, review, and update enrollment applicationsVerify applicant eligibility for Medicare Advantage Plans, ensuring compliance with CMS guidelinesReview applications for completeness, required documents, and accuracy before submissionProcess plan changes, denials, and special election request as applicableMaintain up-to-date knowledge of CMS enrollment guidelines, HIPAA requirements, and company policiesIdentify, document, and escalate enrollment discrepancies or errors in accordance with compliance protocolsPerform qualify check on one's own work to meet accuracy metricsRespond to internal inquiries from agents, brokers, and customer service teams regarding enrollment statusProvide clear, professional communication to resolve application issues in a timely mannerCollaborate with internal departments to ensure prompt resolution of enrollment-related issuesConsistently meet or exceed productivity, accurate, and timeliness goals for enrollment processing (metrics = processing 80-110 applications, about 8-10/hour, they will ramp them to this)Track daily work volumes, turnaround times, and error rates in line with department performance standardsRequirements:High school diploma, GED, or transcriptsMinimum 1 year of data entry experience with strong business or office skills Administrative experience in a healthcare setting highly preferred.Computer proficientSchedule / ShiftMon-Fri (9am-6pm PST), some SaturdaysOvertime will be required On-site

Created: 2025-09-26