Hybrid Medicare Enrollment Specialist

Alignment Healthcare USA, LLC; 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 coordinate with CMS daily files. The role requires data entry, tracking, and collaboration with sales to ensure accurate processing of enrollments and denials.

The position demands at least 2 years of customer service experience and a High School Diploma or GED, with preferred direct experience in Managed Care and Medicare knowledge; bilingual English/Spanish is desirable.

Qualifications

• Minimum 2 years of customer service experience.
• Direct sales or related experience in Managed Care preferred.
• Knowledge of Medicare Managed Care Plans.
• Bi-lingual (English/Spanish) preferred.

Responsibilities

• Sends correspondence to Members or CMS to gather information or provide updates for corrections.
• Submits daily transaction files to CMS and ensures enrollments meet Medicare guidelines.
• Acts as liaison to Sales Representatives and processes enrollment applications.
• Tracks enrollments and assists with compliance mailings and monthly reports.

Skills

Customer service

Communication skills

Leadership & collaboration

Bilingual English/Spanish

Education

High School Diploma or GED

Bachelor's degree or 4 yrs exp

Job description

Alignment Health is seeking a Hybrid Enrollment Representative to manage new plan enrollments, validate data, and coordinate with CMS daily files. The role requires data entry, tracking, and collaboration with sales to ensure accurate processing of enrollments and denials.

The position demands at least 2 years of customer service experience and a High School Diploma or GED, with preferred direct experience in Managed Care and Medicare knowledge; bilingual English/Spanish is desirable.