Medicare Enrollment Specialist II — Remote & Impactful

HealthEdge; United States; A distancia; USD 40.000 - 44.000; Jornada completa

Descripción de la vacante

HealthEdge is seeking an Enrollment Specialist II to ensure accurate enrollment, billing, and data maintenance. You will resolve discrepancies by researching enrollment issues and coordinating with CMS contractors to secure approvals.

Requirements include 3-5 years of Medicare enrollment processing experience, a high school degree, and knowledge of Medicare Advantage and CMS transaction files. This role supports remote US-based work across time zones.

Formación

• 3–5 years of professional experience in processing Medicare enrollment transactions.
• Thorough understanding of Medicare Advantage products and CMS transaction files.
• Medicaid enrollment experience is a plus.
• Experience with CMS interfaces and systems for enrollment and billing functions.
• Ability to analyze enrollment reconciliation data and report KPIs.
• Willingness to learn and collaborate with the team.

Responsabilidades

• Prepare, process, and maintain enrollment and disenrollment requests.
• Verify and maintain applicable eligibility requirements.
• Review and process CMS transactions.
• Review Medicaid eligibility and verification processes.
• Resolve enrollment system rejections per guidelines.
• Reconcile membership reports per CMS requirements.
• Attend trainings and mentor junior team members.
• Collaborate on special projects and process improvements.

Conocimientos

Medicare enrollment processing

CMS transaction files

Data reconciliation

Analytical reporting

Team collaboration

Willingness to learn

Educación

High school degree

Descripción del empleo

HealthEdge is seeking an Enrollment Specialist II to ensure accurate enrollment, billing, and data maintenance. You will resolve discrepancies by researching enrollment issues and coordinating with CMS contractors to secure approvals.

Requirements include 3-5 years of Medicare enrollment processing experience, a high school degree, and knowledge of Medicare Advantage and CMS transaction files. This role supports remote US-based work across time zones.