Enrollment Specialist

Dahl Consulting; Sioux Falls (SD); On-site; USD 28,000 - 32,000; Full time

Job summary

Dahl Consulting is seeking an Enrollment Specialist in Sioux Falls, SD to support membership operations, enrollment accuracy, and regulatory compliance in a 3-month contract (October 2026 – January 2027). This role focuses on data integrity, cross-functional collaboration, and delivering an exceptional member experience.

The Enrollment Specialist will maintain enrollment data, process daily transaction files, audit records for accuracy, and ensure HIPAA and CMS regulatory compliance while

Qualifications

• Strong attention to detail and ability to maintain accurate records.
• Ability to interpret and apply policies, procedures, and regulatory requirements.
• Strong analytical and problem-solving skills.
• Proficiency with computer systems, databases, and Microsoft Office applications.
• Excellent written and verbal communication skills.

Responsibilities

• Maintain enrollment and membership data per policies and regulations.
• Process daily, weekly, and monthly enrollment files from government agencies and partners.
• Audit records for data integrity and regulatory compliance.
• Collaborate with internal teams and external vendors to support enrollment operations.
• Ensure accurate setup of member and group information for claims and billing.

Skills

Attention to detail

Regulatory compliance

Data management

Microsoft Office

Communication skills

Problem solving

Teamwork

Confidentiality

Education

High school diploma or GED

Tools

Enrollment systems

Data entry tools

Job description

Title: Enrollment Specialist

Location: Sioux Falls, SD

Job Type: 3 month contract (October 2026 - January 2027)

Compensation: $20.00 - $23.00 per hour (W2)

Industry: Health Insurance

About The Role

Our client is a leading regional healthcare insurance organization dedicated to helping individuals, families, employers, and Medicare members access quality, affordable healthcare coverage. On their behalf, we are seeking an Enrollment Specialist to support membership operations, enrollment accuracy, and regulatory compliance. This role is ideal for a detail-oriented professional who enjoys working with data, regulations, and cross-functional teams to ensure an exceptional member experience.

Job Description

The Enrollment Specialist is responsible for maintaining accurate member enrollment data, supporting membership retention and growth, and ensuring compliance with federal and state healthcare regulations. This position plays a critical role in enrollment operations by monitoring data transactions, resolving discrepancies, auditing records, and ensuring accurate member and group setup for claims processing and billing.

Key Responsibilities

• Update and maintain enrollment and membership data in accordance with established policies, procedures, and regulatory requirements.
• Ensure compliance with HIPAA, COBRA, Medicare Secondary Payer (MSP) rules, CMS guidelines, and other applicable regulations.
• Monitor and process daily, weekly, and monthly enrollment transaction files received from government agencies, vendors, employers, and other partners.
• Oversee enrollment activities managed by delegated vendors, including member additions, changes, terminations, and ID card processing.
• Download, log, and maintain electronic enrollment files across multiple lines of business.
• Reconcile enrollment data, identify discrepancies, and implement corrective actions to improve data accuracy and operational performance.
• Audit enrollment records to ensure data integrity and compliance with organizational and regulatory standards.
• Collect and transmit enrollment and disenrollment data required by the Centers for Medicare & Medicaid Services (CMS).
• Ensure accurate setup and maintenance of member and group information to support claims administration and premium billing.
• Research, track, and resolve enrollment errors while identifying trends and root causes.
• Process eligibility exceptions and resolve electronic enrollment file discrepancies.
• Collaborate effectively with internal teams and external partners to support membership operations.

Qualifications

Required

• High school diploma or GED equivalent.
• 1-3 years of related administrative, enrollment, insurance, customer service, healthcare operations, or data management experience; or an equivalent combination of education and experience.
• Strong attention to detail and ability to maintain accurate records.
• Ability to interpret and apply policies, procedures, and regulatory requirements.
• Strong analytical and problem-solving skills.
• Proficiency with computer systems, databases, and Microsoft Office applications.
• Excellent written and verbal communication skills.
• Ability to work independently and collaboratively in a team environment.
• Commitment to maintaining confidentiality and handling sensitive information appropriately.

Preferred

• Experience working in the health insurance industry.
• Knowledge of healthcare enrollment processes and eligibility management.
• Familiarity with HIPAA, COBRA, CMS regulations, Medicare enrollment, and coordination of benefits processes.
• Experience performing audits, reconciliations, and data quality assurance activities.
• Experience working with enrollment, claims, or membership administration systems.
• Understanding of federal and state healthcare regulations affecting health plan operations.

Benefits

Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family’s needs. For details, please review the DAHL Benefits Summary: https://www.dahlconsulting.com/benefits-w2fta/.

Equal Opportunity Statement

As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!

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