Medicare Enrollment Specialist II - Remote & Data-Driven

Jobgether SRL; United States; Remote; USD 40,000 - 44,000; Full time

Benefits offered by this job

Fully remote work within United States

Mentorship opportunities

Pre-employment background check

Occasional travel depending on needs

Job summary

Partner Company in the United States is seeking a Commercial Enrollment Specialist II to support accurate member enrollment, billing, and eligibility administration within the healthcare industry. This fully remote, full-time role focuses on Medicare Advantage enrollment processes and resolving complex discrepancies while ensuring regulatory compliance.

You will collaborate with team members and management, prepare documentation for CMS review, reconcile membership reports, and contribute to

Qualifications

• Three to five years of Medicare enrollment experience.
• Strong knowledge of Medicare Advantage rules and CMS transaction files.
• Experience with enrollment reconciliation and reporting on SLAs/KPIs.
• Ability to work across multiple time zones remotely.

Responsibilities

• Prepare, process, and maintain enrollment and disenrollment requests accurately.
• Verify and maintain eligibility per regulations and procedures.
• Review CMS transactions for compliance with enrollment guidelines.
• Investigate enrollment system rejections and resolve discrepancies.
• Maintain CMS membership reports and prepare performance metrics.
• Build case files for CMS review and ensure timely resolution.
• Mentor teammates and contribute to process improvements.
• Communicate issues and quality improvement opportunities to management.

Skills

Medicare enrollment

CMS system knowledge

Discrepancy resolution

Data analysis

Regulatory compliance

Attention to detail

Communication skills

Remote collaboration

Education

High school diploma or equivalent

Tools

CMS interfaces

Job description

Partner Company in the United States is seeking a Commercial Enrollment Specialist II to support accurate member enrollment, billing, and eligibility administration within the healthcare industry. This fully remote, full-time role focuses on Medicare Advantage enrollment processes and resolving complex discrepancies while ensuring regulatory compliance.

You will collaborate with team members and management, prepare documentation for CMS review, reconcile membership reports, and contribute to