Hybrid Medicare Enrollment Specialist (CA)

Alignment Healthcare USA, LLC in; Orange (CA); Hybrid; USD 42,000 - 58,000; Full time

Job summary

Alignment Health is seeking a Hybrid Enrollment Representative in Orange, CA to manage new plan enrollments, research and reconcile enrollments, and ensure timely data entry. You will collaborate with Sales and internal teams while maintaining CMS compliance.

Required: 2+ years of customer service; High School Diploma or GED; Medicare knowledge; English/Spanish bilingual is a plus. MBA preferred and prior Managed Care sales experience is a plus.

Qualifications

• Minimum 2 years of customer service experience.
• Direct sales or related experience in Managed Care is preferred.
• Bi-lingual English/Spanish is a plus.

Responsibilities

• Sends correspondence to Members or CMS to gather information or provide updates for corrections.
• 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 communicates issues to internal teams.
• Conducts data entry of enrollment applications and disenrollments into the data system.
• Tracks pending enrollments for additional information needed for qualification.
• Assists in compliance tasks and related mailings.
• Submits monthly reports on enrollment activity and mailings.

Skills

Customer service

Bilingual EN/ES

Communication skills

Medicare knowledge

Education

High School Diploma or GED

Bachelor's degree or 4 years experience in lieu of education

MBA (preferred)

Job description

Alignment Health is seeking a Hybrid Enrollment Representative in Orange, CA to manage new plan enrollments, research and reconcile enrollments, and ensure timely data entry. You will collaborate with Sales and internal teams while maintaining CMS compliance.

Required: 2+ years of customer service; High School Diploma or GED; Medicare knowledge; English/Spanish bilingual is a plus. MBA preferred and prior Managed Care sales experience is a plus.