Medicare Enrollment Specialist

The Health Plan (THP); Wheeling (WV); On-site; USD 32,000 - 40,000; Full time

Job summary

The Health Plan seeks an Medicare Enrollment Representative to process enrollment and disenrollment requests under CMS guidelines, handle correspondence and reporting, and support Sales during peak periods. The role requires strong communication, accuracy, and confidentiality in a fast-paced environment.

Responsibilities include handling phone inquiries, logging calls, performing enrollment tasks, and coordinating with other units while maintaining PHI security.

Qualifications

• High School Diploma required.
• Typing and computer skills are required.
• Excellent telephone and communication abilities.
• Self-starter with attention to detail and ability to prioritize and meet deadlines.
• Maintain confidentiality and demonstrate mathematical aptitude.
• Strong work ethic and adaptability to changing requirements.

Responsibilities

• Communicate with current and prospective members professionally, accurately and thoroughly.
• Answer prospective sales phone line and route calls to appropriate licensed Sales staff.
• Record all calls accurately in the Customer Service Module or Medicare Call Log.
• Complete a variety of enrollment and disenrollment functions.
• Understand how Enrollment affects other units and departments.
• Assist with the completion of reports in line with CMS requirements (e.g. TRR, BEQs and EDVs).
• Process correspondence and report suspicious issues to Compliance or Management.
• Protect PHI confidentiality for members and staff.
• Overtime may be required to meet CMS timeliness requirements.
• Participate in trainings and maintain a positive and reliable attendance record.
• Assist lobby traffic with Enrollment/Disenrollment questions and concerns.

Skills

Typing and Computer Skills

Telephone and communication skills

Self-starter

Detail oriented

Prioritize and meet deadlines

Maintain confidentiality

Mathematical skills

Good work ethic

Adapt to changes

Education

High School Diploma

Job description

The Health Plan seeks an Medicare Enrollment Representative to process enrollment and disenrollment requests under CMS guidelines, handle correspondence and reporting, and support Sales during peak periods. The role requires strong communication, accuracy, and confidentiality in a fast-paced environment.

Responsibilities include handling phone inquiries, logging calls, performing enrollment tasks, and coordinating with other units while maintaining PHI security.