Medicare Enrollment Specialist

Job Description: Medicare Advantage Enrollment Specialist

This is 100% in office at our St. Louis facility.

Summary: Under the supervision of the Enrollment Supervisor, the Medicare Advantage Enrollment Specialist is responsible for coordinating the enrollment process for all clients.

Essential Functions:

Ø Processes daily enrollment files received from Clients prior to CMS submission (enrollment application, BEQ files, and MARx files)

Ø Works DTRR reports daily and resolves any issues from the DTRR file

Ø Performs daily audits to ensure files processed were done correctly

Ø Maintains Enrollment Tracker daily and sends weekly enrollment updates

Ø Works JIRA tickets and emails received from Clients daily

Ø Retrieves monthly CMS report via Gentran

Ø Submits retroactive adjustments to Reed & Associates or CMS regional office, as needed

Ø Completes Enrollment Data Validation (EDV) Audits monthly

Ø Follows up on enrollment issues given

Ø Communicate any outstanding enrollment issues to leadership

Additional Functions:

Ø Assists with special projects, as needed

Ø Communicates clearly and concisely, with sensitivity to the needs of others

Ø Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employees

Ø Maintains courteous, helpful and professional behavior on the job; displays a willingness and ability to be responsive in a warm and caring manner to all customer groups. Consistently cooperates and supports organization in problem solving issues.

Ø Establishes and maintains effective working relationships with co-workers

Ø Follows all Policies and Procedures and HIPAA regulations

Ø Participates in any recommended or required training sessions

Ø Maintains a safe working environment

Supervisory Responsibility: None

Knowledge, Skills and Abilities:

Ø Educational requirements include a high school diploma or equivalent.

Ø Three years of experience in a health plan management or insurance company, or similar experience, is required. Prior experience working with Medicare Advantage Enrollment is required,

Ø Knowledge and experience using Excel, Microsoft Word and ten-key efficiency; ability to quickly adapt to new systems

Ø Strong knowledge of current computer technology, including the use of computers, printers, computerized file structures and associated software

Ø Skilled in establishing and maintaining effective working relationships with co-workers and clients

Ø Skilled in problem resolution; recommends suggestions to increase accuracy and/or efficiency

Ø Detail-oriented with ability to focus on projects for extended periods

Ø Ability to work independently, seeking supervision as needed

Ø Ability to communicate professionally, clearly and effectively, verbally and in writing

Ø Ability to have superior attendance to effectively fulfill all functions of the position

Ø Ability to independently follow through on assigned tasks, without prompting

Ø Ability to prioritize effectively

Ø Ability to consistently multitask

Physical Demands & Requirements:

Ø Communicate by way of the telephone with participants, customers, vendors and staff

Ø Operate a computer and other office productivity machinery, such as a calculator, copy machine, fax machine and office printer

Ø Remain stationary for extended periods of time

Ø Occasionally exert up to 20 pounds of force to lift, carry, push, pull or move objects

Ø Visual acuity to perform activities such as identifying, inputting, and analyzing data on a computer terminal and/or in hard copy

Ø Occasional reaching to retrieve shelved items

Ø Occasional bending/stooping

Work Environment:

Ø This job operates in a professional office environment with a conversational noise level.

Ø No substantial exposure to adverse environmental conditions is expected

Ø Moderate pressure to meet scheduled appointments and deadlines

Ø Potential for occasional verbal aggression by clients and vendors

Supervised by: Enrollment Supervisor

Job Type: Full-time

Salary: $20.00 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Application Question(s):

• Please provide a contact number and email address.
• Do you have a working knowledge of Medicare part A? This is a requirement.
• Do you have experience with health plan management with an insurance company? Prior experience working with enrollments is required.

Work Location: In person