Medicare Enrollment Specialist II (Fully Remote)

HealthEdge; United States; Remote; USD 60,000 - 75,000; Full time

Job summary

HealthEdge, a provider of AI-powered health insurance infrastructure, seeks a Medicare enrollment specialist for a remote, US-based team.

You will prepare, process, and maintain Medicare enrollment and disenrollment requests, verify eligibility (including Medicaid), and resolve system rejections per CMS and client guidelines; mentor junior staff and collaborate across time zones.

This is a full-time, permanent role.

Qualifications

• High school degree required; 3-5 years of Medicare enrollment processing experience.
• Thorough understanding of Medicare Advantage products and CMS transaction files.
• Experience with CMS interfaces and enrollment/billing functions.
• Remote, US-based position with a full-time, permanent schedule.
• Opportunity to mentor junior team members and contribute to process improvements.
• Work across multiple time zones in a remote or hybrid environment.

Responsibilities

• Prepare, process, and maintain Medicare enrollment and disenrollment requests.
• Verify and maintain all applicable eligibility requirements, including Medicaid.
• Resolve enrollment system rejections based on regulatory and client guidelines.

Skills

Medicare enrollment processing

CMS interfaces

Enrollment/billing functions

Mentoring junior staff

Education

High school degree

Tools

CMS transaction files

Job description

• Prepare, process, and maintain Medicare enrollment and disenrollment requests.
• Verify and maintain all applicable eligibility requirements, including Medicaid.
• Resolve enrollment system rejections based on regulatory and client guidelines.

Requirements:

• High school degree required; 3-5 years of Medicare enrollment processing experience.
• Thorough understanding of Medicare Advantage products and CMS transaction files.
• Experience with CMS interfaces and enrollment/billing functions.
• Remote, US-based position with a full-time, permanent schedule.
• Opportunity to mentor junior team members and contribute to process improvements.
• Work across multiple time zones in a remote or hybrid environment.

HealthEdge

HealthEdge provides AI-powered operational infrastructure for health insurance companies, aiming to modernize operations and improve competitiveness. UST HealthProof, a fast-growing company, focuses on reducing administrative costs and improving healthcare experiences, led by seasoned leaders fostering a supportive, growth-oriented environment.