Enrollment Representative

Medix; Orange (CA); Hybrid; USD 29,000 - 30,000; Full time

Benefits offered by this job

Weekly Pay

Medical insurance

Dental insurance

Vision insurance

Short Term Disability

Life Insurance

Job summary

Medix is seeking an Enrollment Representative for the Orange, CA area to process new Medicare Advantage enrollments with careful data entry and CMS rule compliance. The role involves reviewing applications, verifying eligibility, and collaborating with internal teams to resolve issues.

A hybrid work option is available after initial training. Key duties include entering applications accurately, ensuring completeness, handling plan changes and denials, and maintaining productivity and quality

Qualifications

• 1+ years of data entry experience with strong general business/office skills.
• Comfort with occasionally making outbound phone calls.
• Strong attention to detail, reliability, and a metrics-driven mindset.

Responsibilities

• Accurately enter, review, and update enrollment applications in a timely manner.
• Verify applicant eligibility for Medicare Advantage Plans, ensuring CMS guidelines and HIPAA compliance.
• Review applications for completeness, required documentation, and accuracy prior to submission.
• Process plan changes, denials, and special election requests as applicable.
• Identify and escalate enrollment discrepancies or errors following compliance protocols.
• Perform quality checks to meet accuracy metrics.

Skills

Data entry

Attention to detail

Outbound calls

Education

High school diploma or GED

Job description

Salary: USD21 - USD21 per hour + Medical, Vision, Dental, Weekly Pay, Sick Pay

Position Overview

The Enrollment Representative is responsible for processing all new Medicare Advantage plan enrollments, ensuring high attention to detail and accurate data entry within required timeframes. In this role, you will review applications, verify eligibility under CMS guidelines, and collaborate with internal teams to resolve issues. While primarily a data-driven entry role, you will occasionally make outbound calls to gather missing information. This position offers a great entry point into a rapidly growing Health Plan with cross-training opportunities, potential for extension or permanent placement, and a hybrid work option after initial training.

Responsibilities

• Accurately enter, review, and update enrollment applications in a timely manner.


• Verify applicant eligibility for Medicare Advantage Plans, ensuring strict compliance with CMS guidelines and HIPAA requirements.


• Review applications for completeness, required documentation, and accuracy prior to submission.


• Process plan changes, denials, and special election requests as applicable.


• Identify, document, and escalation enrollment discrepancies or errors following compliance protocols.


• Perform quality checks on individual work to meet established accuracy metrics.


• Maintain up-to-date knowledge of CMS enrollment guidelines and company policies.


• Respond to internal inquiries from agents, brokers, and customer service teams regarding enrollment status.


• Provide clear, professional communication to resolve application issues promptly.


• Collaborate with internal departments to ensure efficient resolution of enrollment-related issues.


• Consistently meet or exceed productivity, accuracy, and timeliness goals (processing 80–110 applications daily, or ~8–10 per hour after ramp-up).


• Track daily work volumes, turnaround times, and error rates in line with department performance standards.


• Make occasional outbound phone calls to applicants or partners to obtain missing information as needed.

Required Qualifications

• High school diploma, GED, or official transcripts.


• 1+ years of data entry experience with strong general business/office skills (healthcare experience is not required).


• Computer proficiency, including basic computer literacy.


• Comfort with occasionally making outbound phone calls.


• Strong attention to detail, reliability, and a metrics-driven mindset.

Preferred Qualifications

• Prior experience in a Healthcare Administrative setting (e.g., call center, data entry, health insurance, or Medicare Advantage experience).

Schedule

Standard Shift: Monday – Friday, 9:00 AM – 6:00 PM.

Location Structure: Onsite during the initial 4-week training period (located in Orange, CA). Potential to transition to a hybrid schedule (3 days onsite / 2 days remote) post-training.

Overtime: Overtime is required based on business needs. Candidates must be flexible to work shifts between 8:00 AM – 8:00 PM Monday through Friday, as well as occasional Saturdays (no Sunday work).

Compensation

$21.00 – $22.00 / hour

Weekly Pay, Medical, Dental, Vision, Short Term Disability, and Life Insurance