Job Summary

We are seeking an experienced Enrollment Coordinator I to join our team. This role plays a crucial role in the enrollment process by reviewing and submitting enrollment requests subject to all CMS regulations. This position requires attention to detail to ensure the accuracy and timeliness of acknowledgements are sent to members. responsible for overseeing student admissions, recruitment, and enrollment processes at our educational institution.

Responsibilities

Review and submit enrollment request received as well as maintaining accuracy and timeliness of acknowledgment to members

Resolve member issues and sustain quality member care

Audits data entered into the internal systems to ensure data integrity and quality

Analyzes and interprets out of area indicator reports submitted by CMS and determine action to be taken

Identify trends and risks

Stay up to date on all CMS Enrollment Regulations

Ensure quality and compliance to meet applicable guidelines

Ensure timely, accurate and complete submissions to CMS

Review prospective enrollees are appropriately screened to meet eligibility requirements within regulatory guidelines and timelines

Required member mailings are sent timely and within regulatory guidelines

Responsible for ensuring the completeness, quality and eligibility criteria of member’s application to meet Enrollment Requirements.

Ensure all completed applications are submitted within required time frames.

Utilizes various computer systems and applications to perform daily functions.

Understands the BEQ and TRR processes

Requirements And Skills

High School Diploma

Two Years Of Medicare Advantage Experience Required

Knowledge of health plan benefits, processes and Operations

Prior experience with Commercial and Medicare Advantage Plans

Attention to detail and problem solving

Excellent communication skills

TPA Experience Preferred

Work weekends and company holidays as needed based on business needs

Detailed Oriented with the ability to conduct research and identify steps to resolve issues to completion

Ability to meet Enrollment timelines.

Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position

Job Type: Full-time

Pay: $22.00 - $30.00 per hour

Expected hours: 40 per week

Benefits

Dental insurance

Health insurance

Paid time off

Vision insurance

Experience

Processing Medicare Enrollments: 2 years (Required)

Work Location: Remote

Qualexa Healthcare

Details

New Jobs

Enrollment Coordinator - (Medicare Enrollment Processing) 100% remote

Enrollment Coordinator - (Medicare Enrollment Processing) 100% remote

Enrollment Coordinator - (Medicare Enrollment Processing) 100% remote