Individual Product Enrollment Specialist

TEKsystems•Virginia Beach, VA

2d•$20 - $21•Remote

About The Position

The Enrollment Specialist will support the Enrollment Department, which is responsible for member eligibility and enrollment. This team ensures member information is accurately loaded, updated, and maintained across systems, including the core enrollment system and pharmacy system, so there are no downstream impacts to member coverage, benefits, claims, pharmacy access, or coordination of care. This role will process a high volume of manual applications as well as 834 electronic enrollment files, which are files received from various employer groups to upload and maintain group membership information. The Enrollment Specialist will be responsible for reviewing enrollment requests, identifying and resolving errors, validating information, and ensuring all data is correct in the appropriate systems. On the first day, the new hire will complete departmental orientation. The Team Coordinator will review expectations for the employee, departmental policies, team workflows, and role-specific responsibilities. Training will last approximately 5 days, during which the employee will learn the basic functions of the job and receive hands-on training. After the initial training period, the new hire will be partnered with a seasoned Enrollment Specialist. The experienced Enrollment Specialist will observe their work, provide coaching and feedback, and help determine when the employee is ready to work independently. Feedback from the seasoned Enrollment Specialist will help the team determine when the new hire is ready to be released to manage assigned work on their own. Once trained, day-to-day responsibilities will include working through emails, responding to group or member inquiries, researching enrollment questions, processing updates, and making sure systems match what the group, member, broker, or benefit administrator is requesting. The Enrollment Specialist will process enrollments, terminations, demographic updates, manual applications, 834 file-related updates, and other enrollment-related transactions. uses a shared enrollment email mailbox that is worked by multiple team members throughout the day. Emails are categorized so the team can assign and track work across individuals. The Enrollment Specialist will be responsible for managing assigned emails, researching requests, resolving discrepancies, correcting errors, and ensuring all updates are completed accurately and timely. Accuracy is critical in this role because errors in eligibility or enrollment can directly impact a member’s access to care, claims processing, pharmacy benefits, and overall coordination of care.

Requirements

Proficiency in Microsoft Outlook and Microsoft Teams.
Experience with Enrollment and Claims processes.

Nice To Haves

Previous individual plan, marketplace, exchange, or health insurance enrollment experience.

Responsibilities

Process a high volume of manual applications and 834 electronic enrollment files.
Review enrollment requests, identify and resolve errors, and validate information.
Ensure all data is correct in the appropriate systems.
Respond to group or member inquiries.
Research enrollment questions.
Process updates and ensure systems match requests from groups, members, brokers, or benefit administrators.
Process enrollments, terminations, demographic updates, manual applications, 834 file-related updates, and other enrollment-related transactions.
Manage assigned emails from a shared enrollment mailbox.
Research requests, resolve discrepancies, and correct errors.
Ensure all updates are completed accurately and timely.