REMOTE Medicare Enrollment Specialist

TEKsystems; United States; Remoto; USD 43.000 - 53.000; Tempo pieno

Descrizione del lavoro

TEKsystems is seeking a Medicare Enrollment Analyst I to support daily enrollment operations for a D-SNP product line, ensuring accurate, timely, and CMS-compliant processing while delivering a high-quality member experience.

The role collaborates with Sales and Customer Service, handles demographic updates, enrollment changes, fallout queues, and data integrity across systems, all within CMS guidelines. Contract position based out of Santa Barbara, CA with remote work.

Competenze

• High school diploma or equivalent required.
• 1+ year experience in health plan operations, enrollment processing.
• Knowledge of enrollment processes and membership administration.
• Strong data entry with high accuracy and attention to detail.
• Proficient in MS Office (Excel, Word, Outlook).
• Able to manage multiple priorities in a fast-paced environment.
• Strong organizational, problem-solving, and communication skills.
• Familiarity with CMS enrollment regulations preferred.

Mansioni

• Manage returned mail and update member records to maintain accurate demographics.
• Process member demographic changes and enrollment updates accurately and timely.
• Review, investigate, and resolve enrollment fallout queues per CMS guidelines and internal policies.
• Maintain accurate enrollment records and ensure data integrity across systems.
• Collaborate with Sales to obtain missing information and resolve enrollment issues.
• Work with Customer Service on member eligibility and enrollment inquiries.
• Monitor processes for data or quality concerns and escalate as needed.
• Ensure enrollment transactions meet service level agreements and deadlines.
• Contribute to continuous improvement initiatives in enrollment operations.

Conoscenze

Data entry

Attention to detail

Multitasking

Communication

CMS knowledge

Formazione

High school diploma or equivalent

Strumenti

Excel

Word

Outlook

Descrizione del lavoro

Candidates must live in the following counties: Ventura County, Santa Barbara County, San Luis Obispo County, Monterey County or Santa Cruz County

Job Summary

The Medicare Enrollment Analyst I supports the daily enrollment operations of the health plan's (D-SNP) product line. This role is responsible for ensuring accurate, timely, and compliant member enrollment processing while delivering a high-quality member experience. The analyst collaborates cross-functionally with internal teams to maintain enrollment integrity and support operational excellence in accordance with CMS regulations and organizational standards.

Essential Duties & Responsibilities

Responsibilities include, but are not limited to:

• Manage returned mail and update member records as needed to maintain accurate demographic information.
• Process member demographic changes and enrollment updates in a timely and accurate manner.
• Review, investigate, and resolve enrollment fallout queues to ensure compliance with CMS guidelines and internal policies.
• Maintain accurate enrollment records and ensure data integrity across systems.
• Partner with the Sales team to obtain missing application information and assist in resolving enrollment-related issues.
• Collaborate with Customer Service to address member eligibility and enrollment inquiries.
• Monitor enrollment processes for potential system, data, or quality concerns and escalation issues to management or Enrollment Analysts as appropriate.
• Support departmental goals by ensuring enrollment transactions are completed accurately and within established service level agreements.
• Contribute to continuous improvement initiatives that enhance enrollment operations and member experience.

Required Skills & Qualifications

• High school diploma or equivalent required.
• Minimum of one (1) year of experience in health plan operations, with a focus on enrollment processing.
• Knowledge of health plan enrollment processes and membership administration.
• Strong data entry skills with a high level of accuracy and attention to detail.
• Experience working with Microsoft Office applications, including Excel, Word, and Outlook.
• Ability to manage multiple priorities in a fast-paced environment while meeting deadlines.
• Strong organizational, problem-solving, and communication skills.
• Familiarity with CMS enrollment regulations and Medicare enrollment processes preferred.

Preferred Experience

• Experience working with Medicare Advantage, D-SNP, or other government-sponsored health plan products.
• Knowledge of CMS enrollment guidelines and compliance requirements.
• Prior experience resolving enrollment discrepancies and eligibility issues within a health plan environment.

Job Type & Location

This is a Contract position based out of Santa Barbara, CA.

Pay and Benefits

The pay range for this position is $31.17 - $38.19/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Santa Barbara, CA.

Application Deadline

This position is anticipated to close on Nov 2, 2026.

Workplace Type

This is a fully remote position.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About TEKsystems and TEKsystems Global Services

Were a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. Were a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.