Medicare Enrollment Reconciliation Specialist

Alohacare; Honolulu (HI); On-site; USD 23,000 - 30,000; Full time

Benefits offered by this job

Health insurance

Paid time off

401k plan

Vision insurance

Job summary

AlohaCare is seeking an Enrollment Reconciliation Specialist in Hawaii to oversee Medicare D-SNP enrollment reconciliation and CMS/MARx transactions. You will coordinate with internal teams and CMS to ensure data accuracy across systems, resolving complex discrepancies that affect member eligibility and claims.

The role requires advanced Excel and data-reconciliation skills, and experience with CMS processes and audits.

Qualifications

• Experience with CMS/MARx enrollment processes.
• Experience handling CMS 834 transactions and retroactive enrollment processing.
• Experience supporting CMS audits and regulatory requirements.

Responsibilities

• Research root causes of enrollment discrepancies and develop corrective actions.
• Manage reinstatements and retroactive enrollment changes through resolution.
• Reconcile Medicare D-SNP enrollment with Medicaid/QUEST eligibility.
• Validate enrollment changes and their downstream impact on claims and benefits.
• Maintain reconciliation tracker, issue logs, and management reporting.
• Provide guidance to enrollment staff on complex reconciliation issues.
• Develop reporting showing enrollment status, discrepancies, and resolution progress.

Skills

Advanced Excel

Data reconciliation

CMS/MARx knowledge

Analytical thinking

Time management

Tools

MS Word

MS Excel

MS Access

Outlook

PowerPoint

Job description

AlohaCare is seeking an Enrollment Reconciliation Specialist in Hawaii to oversee Medicare D-SNP enrollment reconciliation and CMS/MARx transactions. You will coordinate with internal teams and CMS to ensure data accuracy across systems, resolving complex discrepancies that affect member eligibility and claims.

The role requires advanced Excel and data-reconciliation skills, and experience with CMS processes and audits.