Remote Medicare Enrollment & Billing Ops Lead

Health Care Service Corp.; Nashville (TN); On-site; USD 42,000 - 93,000; Full time

Benefits offered by this job

Health benefits

401(k) savings plan

Pension plan

Paid time off

Disability insurance

Tuition reimbursement

Employee assistance program

Paid holidays

Job summary

Health Care Service Corporation (HCSC) is hiring to support oversight of PDP Enrollment & Premium Billing, ensuring CMS compliance and audit readiness. You will collaborate with vendors and internal teams to monitor metrics, review SLAs, and report findings.

The role emphasizes analysis, problem solving, and the ability to operate in a fast-paced, matrixed environment, with a REMOTE work setup for eligible states.

Qualifications

• Bachelor's Degree or equivalent experience.
• 3-4 years Medicare or government program experience in eligibility, premium billing, or healthcare operations.
• Proficiency with Microsoft Word, Excel, Outlook, PowerPoint.
• Must be self-motivated and able to work in a fast-paced, matrixed environment.
• Ability to work independently as well as in a team.
• Excellent conceptual and analytical skills with the ability to link interfacing systems and processes.
• Strong problem-solving skills and attention to detail.
• Ability to analyze situations and handle ambiguity.
• Capacity to learn process and product information quickly and efficiently.
• Excellent organizational and written/verbal communication skills.

Responsibilities

• Support daily oversight and monitoring of PDP Enrollment & Premium Billing with vendor and internal/external partners.
• Interpret new CMS requirements to ensure compliance.
• Monitor operational metrics and daily inventory to identify potential issues.
• Review SLA and coordinate with partners to address issues.
• Manage weekly monitoring activities and prepare leadership reports.
• Support audits and documentation for CMS and internal teams.

Skills

MS Office proficiency

Analytical skills

Problem solving

Independent worker

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Outlook

PowerPoint

Job description

Health Care Service Corporation (HCSC) is hiring to support oversight of PDP Enrollment & Premium Billing, ensuring CMS compliance and audit readiness. You will collaborate with vendors and internal teams to monitor metrics, review SLAs, and report findings.

The role emphasizes analysis, problem solving, and the ability to operate in a fast-paced, matrixed environment, with a REMOTE work setup for eligible states.