Senior Enrollment Representative

Avispa Technology•Los Angeles, CA

1d•Remote

About The Position

A leading medical institution is seeking a Senior Enrollment Representative to support Medicare membership enrollment operations, reconciliation, disenrollment, and benefits coordination. This role involves working with applicable state and federal files, managing and analyzing enrollment-related data, and assisting with process improvement and operational initiatives. The representative will need to prioritize changing assignments, deadlines, and operational requests while maintaining accuracy and compliance.

Requirements

3-5 years of experience within a Medicare health plan or Managed Care environment.
Experience with Medicare enrollment, disenrollment, and reconciliation.
Knowledge of Medicare and CMS enrollment and billing regulations.
Proficiency with Microsoft Excel, Word, and PowerPoint.
Strong understanding of healthcare and Managed Care operations.

Nice To Haves

Experience in Medicare Advantage Prescription Drug Plan (MAPD) is preferred.
Experience with 834 EDI transactions/files is preferred.
Experience working with CMS and California DHS files is preferred.
Experience with Medicare and Medicaid enrollment is preferred.
Managed Care experience is preferred.
Business analysis and process improvement experience is preferred.
Experience with data visualization tools is preferred.

Responsibilities

Support Medicare membership enrollment, billing requirements, disenrollment, reconciliation, and benefits coordination, involving applicable state and federal files.
Manage and analyze enrollment-related data, identifying discrepancies or issues.
Assist with process improvement, business analysis, and operational initiatives.
Prioritize changing assignments, deadlines, and operational requests while maintaining accuracy and compliance.