Medicare Enrollment Specialist – Peak Health

About This Opportunity

We are representing a confidential healthcare organization in their search for a Medicare Enrollment Specialist. Our client is building an innovative health plan team and needs experienced professionals who understand Medicare processes and can ensure seamless member enrollment operations.

This is a remote position based in the United States, working 40 hours per week in a standard office environment.

Responsibilities

• Analyze and process Medicare enrollment forms, verifying validity, completion, and accuracy
• Determine whether to enroll, outreach to, or reject applications while following organizational policies
• Review and evaluate all enrollment documents for quality control before final entry
• Maintain Medicare member enrollment records annually, documenting changes, updates, and required outreach
• Resolve enrollment issues to ensure efficient member experience
• Manage coordination of benefits (COB) on member records
• Process SNP applications and verify eligibility, including dual-entitlement and service area residence
• Meet production and quality standards while maintaining workqueues according to department benchmarks
• Manage late enrollment penalties (LEP) for Medicare Advantage Prescription Drug enrollees
• Participate in system testing for development rollouts and department planning for Open Enrollment
• Develop and deliver training to new team members
• Communicate effectively with internal and external stakeholders

What We're Looking For

Minimum Requirements:

• High school diploma or equivalent
• Two years of experience with medical or institutional data entry
• Two years of customer service experience
• OR one year of Medicare eligibility and Medicare enrollment processing experience

Preferred Qualifications:

• Associate degree or higher in a healthcare-related field
• Three to five years of Medicare enrollment processing and customer service experience
• Two years of experience with Medicare elections, transaction codes, and reconciliation operations
• Two years managing late enrollment penalties for MAPD enrollees
• Familiarity with CMS tools and resources, particularly the MARx website
• At least one year of experience with system/user acceptance testing
• At least one year of experience developing and delivering training programs

Essential Skills:

• Strong knowledge of medical insurance enrollment processes
• Proficiency with administrative and clerical procedures, including word processing and records management
• Ability to navigate multiple systems simultaneously
• Exceptional attention to detail and organizational abilities
• Excellent written and oral communication skills, including telephone etiquette
• Problem-solving skills using predefined methods and guidelines
• Ability to perform multiple tasks simultaneously in a fast-paced environment
• Comfortable with Microsoft Office Suite and healthcare software systems

How We Work With You

As a recruiting partner for this confidential client, our talent team at Get A Job.ai manages the entire application process. When you apply through our platform, a dedicated recruiter will screen your qualifications and experience. If there's a strong match, we'll submit your profile to our client for consideration and guide you through each stage of the interview process.

Important: Please apply only through Get A Job.ai. Do not contact the client directly, as we are managing this search exclusively.

Pay

Compensation details will be discussed with qualified candidates during the screening process.

Equal Employment Opportunity: Get A Job.ai is committed to inclusive recruiting practices. We welcome applications from candidates of all backgrounds and work with our clients to ensure fair consideration throughout the hiring process.