Enrollment Operations Specialist — Compliance & Audits

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 42,000 - 54,000; Full time

Job summary

CommunityCare HMO Inc. seeks an experienced enrollment operations professional to process advanced employer group enrollment and membership transactions, perform audits, and ensure accurate, timely updates across systems.

You will review reports, reconcile data, administer renewal and PCP routes, generate notices, and maintain policy documentation while complying with SLAs and regulatory guidance. Strong communication and attention to detail are essential.

Qualifications

• Requires strong communication and organizational skills.
• Ability to work with multiple tasks with minimal supervision.
• Experience in administrative roles within healthcare or insurance preferred.

Responsibilities

• Process enrollment transactions and audits for groups and members.
• Review enrollment reports and apply system updates or corrections.
• Reconcile transactions across systems and records to ensure accuracy.
• Manage renewal and PCP routes and conduct new group audits.
• Generate enrollment-related notices and correspondence.
• Audit output files and ID cards prior to release.
• Document and resolve HICS cases related to enrollment.
• Maintain policies and process documentation for audit readiness.
• Adhere to SLAs and regulatory guidance in enrollment operations.
• Perform other duties as assigned.

Skills

Strong oral and written communication

Self-motivated with ability to multita

Strong organizational skills

Ability to work with personnel at var

High attention to detail

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

CommunityCare HMO Inc. seeks an experienced enrollment operations professional to process advanced employer group enrollment and membership transactions, perform audits, and ensure accurate, timely updates across systems.

You will review reports, reconcile data, administer renewal and PCP routes, generate notices, and maintain policy documentation while complying with SLAs and regulatory guidance. Strong communication and attention to detail are essential.