Remote Medicare Enrollment Specialist II

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

Job summary

HealthEdge is seeking an Enrollment Specialist II to join our US remote team. You will ensure accurate enrollment, billing, and data maintenance for Medicare members, resolving discrepancies with CMS contractors and clients.

The role emphasizes compliance with CMS guidelines, data reconciliation, and timely processing of enrollment transactions in a fast-paced environment. Ideal candidates have 3–5 years of Medicare enrollment experience, strong analytical and communication skills, and a

Qualifications

• Minimum high school diploma and 3–5 years of Medicare enrollment processing experience.
• Deep knowledge of Medicare Advantage, CMS transaction files, and enrollment guidelines.
• Experience with CMS interfaces and systems for Medicare enrollment and billing.
• Strong analytical skills to reconcile data, monitor SLAs, and report KPIs.
• Willingness to learn, team oriented, and able to work across time zones.

Responsibilities

• Process enrollment and disenrollment requests accurately and timely.
• Verify eligibility and complete CMS transactions.
• Reconcile enrollment data and resolve rejections per guidelines.
• Collaborate on projects and provide mentorship to junior team members.
• Maintain communication with management and take preventive actions for accuracy.

Skills

Medicare enrollment processing

CMS data analysis

Regulatory compliance

Team collaboration

Education

High school degree

Tools

CMS interfaces

Job description

HealthEdge is seeking an Enrollment Specialist II to join our US remote team. You will ensure accurate enrollment, billing, and data maintenance for Medicare members, resolving discrepancies with CMS contractors and clients.

The role emphasizes compliance with CMS guidelines, data reconciliation, and timely processing of enrollment transactions in a fast-paced environment. Ideal candidates have 3–5 years of Medicare enrollment experience, strong analytical and communication skills, and a