Commercial Enrollment Specialist II

HealthEdge

. Prepare, process, and maintain enrollment and disenrollment requests .

Posted 9/23/2026full-timeRemote • United StatesMid-LevelSenior💰 $40,000 - $44,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in processing Medicare enrollment transactions and a thorough understanding of Medicare Advantage products and CMS guidelines. Capable of analyzing enrollment data and collaborating effectively within a team environment.

Highest-signal resume keywords

Medicare Enrollment ProcessingCMS Transaction FilesMedicaid Enrollment ExperienceEnrollment Reconciliation AnalysisTeam Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Enrollment ProcessingEligibility VerificationData AnalysisMembership ReconciliationCMS InterfacesMedicare Advantage ProductsRegulatory ComplianceTransaction Processing

Soft Skills

Strong Work EthicAdaptabilityMentoringCommunicationWillingness to Learn

Certifications & Qualifications

High School Degree

Industry Keywords

MedicareCMSEnrollment GuidelinesKPI ReportingSLA Reporting

About the role

Key responsibilities & impact

Prepare, process, and maintain enrollment and disenrollment requests
Verify and maintain applicable eligibility requirements
Review and process CMS transactions
Review Medicaid eligibility and complete verification processes
Resolve enrollment system rejections according to regulatory and client-specific guidelines
Reconcile membership reports as required by CMS
Attend and successfully complete client and employer training
Mentor junior team members
Collaborate on special projects, including process documentation, training, and quality reviews
Communicate with management about issues and concerns and take preventive measures to ensure case accuracy and quality
Participate in management-assigned projects
Perform other assigned duties

Requirements

What you’ll need

High school degree required
3–5 years of professional experience processing Medicare enrollment transactions
Thorough understanding of Medicare Advantage products, CMS transaction files, and enrollment-related guidelines
Medicaid enrollment experience is a plus
Experience with CMS interfaces and systems for Medicare Advantage enrollment and billing functions
Ability to analyze enrollment reconciliation data and report SLAs, KPIs, and other operations reports
Ability to present findings in a structured way
Willingness to learn
Ability to collaborate as a team member
Strong work ethic
Ability to adapt quickly to a challenging environment
Self-starter and quick learner
Ability to work across multiple time zones
Candidates may be required to complete a pre-employment criminal background check

Benefits

Comp & perks

Training scheduled by the client and employer
Mentorship opportunities
Hybrid or remote work environment
Potential travel dependent on company needs
Reasonable accommodations for individuals with disabilities
Equal opportunity employment
Permanent employment