Hybrid Medicare Enrollment Specialist

Alignment Health; Orange (CA); Hybrid; USD 42,000 - 58,000; Full time

Job summary

Alignment Health is seeking a Hybrid Enrollment Representative to manage new plan enrollments, validate data, and reconcile CMS daily files to ensure timely processing.

The role requires strong customer service, knowledge of Medicare Managed Care, and the ability to collaborate with internal teams. Bilingual English/Spanish is preferred, with opportunities for growth in a fast‑growing company.

Qualifications

• Minimum 2 years of customer service experience.
• Bachelor's degree or four years additional experience in lieu of education.
• Bi-lingual English/Spanish preferred.
• Knowledge of Medicare Managed Care Plans.

Responsibilities

• Sends correspondence to Members or CMS to gather information or updates.
• Ensures the TRR is reviewed daily.
• Submits daily transaction files to CMS.
• Ensures enrollments, denials and rejects meet Medicare guidelines.
• Acts as a liaison to the Sales Representatives and ensures new enrollments are processed properly.
• Conducts data entry of all enrollment applications and disenrollments into plan's data system.
• Tracks all pending enrollments for additional information needed for qualification.
• Assists in departmental compliance tasks including surveys and notices.
• Submits monthly reports to the Membership Manager, enrollment applications processed and returned, and number of mailed packets.

Skills

Customer service

Education

High School Diploma or GED

Bachelor's degree or 4 years additional experience

MBA

Job description

Alignment Health is seeking a Hybrid Enrollment Representative to manage new plan enrollments, validate data, and reconcile CMS daily files to ensure timely processing.

The role requires strong customer service, knowledge of Medicare Managed Care, and the ability to collaborate with internal teams. Bilingual English/Spanish is preferred, with opportunities for growth in a fast‑growing company.