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Medicare Enrollment Specialist
Peak Health. Analyze and process Medicare enrollment forms, checking validity, completion, and accuracy .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare Enrollment Processing, ensuring accuracy and compliance while managing member records and resolving enrollment issues. Proficient in data entry, quality control, and effective communication with internal and external stakeholders.
Highest-signal resume keywords
Medicare Enrollment ProcessingData Entry AccuracyCustomer Service ExperienceQuality Control EvaluationTraining Development
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data EntryMedicare EligibilityQuality ControlEnrollment ProcessingTransaction CodesReconciliation OperationsLate Enrollment Penalty ManagementSystem TestingMARx Website NavigationMedical Insurance Enrollment
Soft Skills
Communication SkillsInterpersonal SkillsProblem-Solving SkillsAttention to DetailOrganizational Skills
Tools & Technologies
CMS ToolsMARx Website
Industry Keywords
MedicareCustomer ServiceHealthcareAdministrative ProceduresClerical Procedures
About the role
Key responsibilities & impact- Analyze and process Medicare enrollment forms, checking validity, completion, and accuracy
- Determine whether to enroll, conduct outreach, or reject applications according to organizational policies and procedures
- Review and evaluate documents for quality control before final entry of member enrollment forms
- Determine accuracy and completeness of member form information and enter/verify form data
- Resolve enrollment issues to ensure an efficient member experience
- Maintain Medicare member enrollment records, including changes, updates, and outreach
- Meet production and quality standards and maintain department workqueues
- Communicate effectively with internal and external staff
- Escalate issues to the appropriate level of supervision
- Ensure accuracy of data entry and record maintenance
- Manage coordination of benefits on member records
- Develop and deliver department training to new hires
- Participate in system testing for development rollouts
- Participate in department planning for Open Enrollment
- Process SNP applications and verify eligibility, including dual entitlement and residence within the service area
- Report to the Enrollment Manager
Requirements
What you’ll need- High School diploma or equivalent AND two (2) years of experience working with medical or institutional data entry AND two (2) years of customer service experience; OR High School diploma or equivalent AND one (1) year of Medicare eligibility and Medicare Enrollment processing experience; OR Bachelor's degree
- Preferred: Associate Degree or greater in related healthcare field
- Preferred: Three (3) to five (5) years of Medicare Enrollment processing and customer service experience
- Preferred: Two (2) years of experience with Medicare elections, transaction codes, and reconciliation operations
- Preferred: Two (2) years managing late enrollment penalty (LEP) for MAPD enrollees
- Familiarity with navigating CMS tools and resources, particularly the MARx website
- Preferred: At least one (1) year of experience with system/user acceptance testing
- Preferred: At least one (1) year of experience with developing and delivering trainings
- Familiarity with medical insurance enrollment processes
- Working knowledge of administrative and clerical procedures and systems, including word processing and managing files and records
- Ability to take direction and navigate multiple systems simultaneously
- Excellent written and oral communication, customer service, interpersonal, and telephone etiquette skills
- Ability to solve problems using predefined methods and guidelines
- Exceptional attention to detail, organization, and ability to perform multiple tasks simultaneously
- Ability to sit for extended periods of time
Benefits
Comp & perks- Full-time schedule of 40 hours per week