Medicare Enrollment & Eligibility Specialist

Socket.dev; Chicago (IL); On-site; USD 42,000 - 68,000; Full time

Job summary

Zing Health Plan is seeking an Enrollment Specialist to join our Enrollment Team. The Enrollment Specialist is responsible for performing duties related to enrollment of Medicare beneficiaries and making eligibility determinations based on CMS Part A/Part B guidelines.

The role requires processing enrollments and disenrollments, maintaining accurate member records, and ensuring compliance with CMS and Zing Health policies.

Qualifications

• Bachelor’s degree preferred.
• Knowledge of managed care operations.
• Ability to work independently, set priorities and meet deadlines.
• 1+ years’ experience with Medicare preferred.
• Strong knowledge/Proficiency with MS Office

Responsibilities

• Ensure the accuracy and timeliness of processing enrollments and disenrollment in compliance with Medicare regulations and Zing Health policies.
• Analyze information to determine eligibility in accordance with CMS and Zing Health guidelines.
• Process daily applications and disenrollments in membership systems for CMS transmission.
• Maintain enrollment records and update eligibility in membership systems.
• Identify election periods based on beneficiary history and regulatory guidance.
• Support daily review and processing of CMS files and reports.
• Generate correspondence to outreach to members as needed.
• Adhere to regulatory updates and training materials.

Skills

Independence

Prioritization

Deadline-driven

Education

Bachelor's degree preferred

Tools

MS Office

Job description

Zing Health Plan is seeking an Enrollment Specialist to join our Enrollment Team. The Enrollment Specialist is responsible for performing duties related to enrollment of Medicare beneficiaries and making eligibility determinations based on CMS Part A/Part B guidelines.

The role requires processing enrollments and disenrollments, maintaining accurate member records, and ensuring compliance with CMS and Zing Health policies.