Medicare Enrollment & Eligibility Specialist

MCS Puerto Rico; San Juan (PR); Presencial; USD 42 000 - 54 000; Tempo integral

Resumo da oferta

MCS Puerto Rico seeks a detail-oriented enrollment administrator to manage enrollment, disenrollment, eligibility, and benefit maintenance within regulatory guidelines. You will review documents, ensure data integrity, and coordinate with internal stakeholders to resolve issues.

The role requires handling multiple systems, meeting SLAs, and documenting actions for audit readiness. Bilingual English/Spanish capabilities are desired to support diverse member inquiries in Puerto Rico.

Qualificações

• Bachelor’s degree (or equivalent) required; six months of enrollment experience preferred.
• Experience with Medicare Advantage products preferred.
• Spanish and English language requirements noted in the posting.

Responsabilidades

• Process enrollment, disenrollment, cancellation, reinstatement, and coverage changes within SLAs and timelines.
• Determine member eligibility and establish effective dates and eligibility periods.
• Identify incomplete applications and initiate return processes with notified departments.

Conhecimentos

Enrollment processes

Regulatory compliance

Analytical review

Formação académica

Bachelor's Degree

Associate’s Degree

High School Diploma

Descrição da oferta de emprego

MCS Puerto Rico seeks a detail-oriented enrollment administrator to manage enrollment, disenrollment, eligibility, and benefit maintenance within regulatory guidelines. You will review documents, ensure data integrity, and coordinate with internal stakeholders to resolve issues.

The role requires handling multiple systems, meeting SLAs, and documenting actions for audit readiness. Bilingual English/Spanish capabilities are desired to support diverse member inquiries in Puerto Rico.