Enrollment Specialist I

Western Health Advantage•Sacramento, CA

6d•$20 - $22•Hybrid

About The Position

Western Health Advantage is looking for a motivated and detail-oriented Enrollment Specialist I to join our growing team. In this role, you will play an important part in ensuring our members receive accurate, timely enrollment support while delivering excellent service to brokers, employer groups, and Individual Advantage members. This is an excellent opportunity for someone with health plan enrollment experience who enjoys problem-solving, working with data, and providing responsive customer support in a collaborative environment.

Requirements

High School Diploma or equivalent.
2+ years of health plan enrollment experience (HMO experience preferred).
Ability to work extended hours during the week and Saturdays during Open Enrollment periods.
Strong attention to detail and commitment to accuracy.
Excellent communication skills with the ability to support members, brokers, and internal teams.
Intermediate computer proficiency including:
Email and database systems
Word processing and spreadsheets
Creating formulas and graphs in Excel and importing them into Word documents
Ability to read, write, speak, and understand the primary language(s) used in the workplace.

Nice To Haves

Experience with Facets Application Software.
Previous experience supporting enrollment operations within a health plan.

Responsibilities

Respond to incoming calls from brokers, employer groups, and Individual Advantage members regarding eligibility and enrollment inquiries.
Communicate eligibility requirements and enrollment status updates to brokers, employer groups, and internal teams.
Process enrollment-related transactions including: Member additions and terminations
ID card requests
Primary Care Physician (PCP) changes
Address updates
Review and process paper and electronic enrollment forms with strong attention to detail.
Maintain a detailed working knowledge of enrollment requirements outlined in the Evidence of Coverage Handbook and Group Service Agreement.
Achieve and maintain data entry accuracy and timeliness scores of 97% or higher.
Collaborate with Individual Sales and Premium Billing teams to resolve escalated cases.
Participate in team meetings, technical discussions, and operational updates.
Support additional projects and department initiatives as needed.