Medicare Enrollment Specialist

TEKsystems

. Manage returned mail and update member records to maintain accurate demographic information .

Posted 10/27/2026contractRemote • California • United StatesJunior💰 $31 - $38 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in health plan enrollment processes and membership administration, ensuring data integrity and compliance with CMS guidelines. Strong organizational and problem-solving skills are essential for managing multiple priorities and enhancing member experience.

Highest-signal resume keywords

Health Plan Enrollment ProcessingData Entry AccuracyCMS Enrollment RegulationsMedicare Advantage ExperienceOrganizational Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Enrollment ProcessingData Integrity ManagementDemographic Changes ProcessingEnrollment Discrepancy ResolutionAttention to Detail

Soft Skills

Problem-Solving SkillsCommunication SkillsOrganizational Skills

Tools & Technologies

Microsoft OfficeExcelWordOutlook

Industry Keywords

CMS GuidelinesMedicare Enrollment ProcessesHealth Plan OperationsMember EligibilityEnrollment Transactions

About the role

Key responsibilities & impact

Manage returned mail and update member records to maintain accurate demographic information
Process member demographic changes and enrollment updates accurately and promptly
Review, investigate, and resolve enrollment fallout queues in compliance with CMS guidelines and internal policies
Maintain accurate enrollment records and data integrity across systems
Partner with Sales to obtain missing application information and resolve enrollment-related issues
Collaborate with Customer Service on member eligibility and enrollment inquiries
Monitor enrollment processes for system, data, or quality concerns and escalate issues as appropriate
Complete enrollment transactions accurately within established service level agreements
Contribute to continuous improvement initiatives enhancing enrollment operations and member experience

Requirements

What you’ll need

High school diploma or equivalent required
Minimum of one (1) year of experience in health plan operations, with a focus on enrollment processing
Knowledge of health plan enrollment processes and membership administration
Strong data entry skills with a high level of accuracy and attention to detail
Experience working with Microsoft Office applications, including Excel, Word, and Outlook
Ability to manage multiple priorities in a fast-paced environment while meeting deadlines
Strong organizational, problem-solving, and communication skills
Familiarity with CMS enrollment regulations and Medicare enrollment processes preferred
Experience working with Medicare Advantage, D-SNP, or other government-sponsored health plan products
Knowledge of CMS enrollment guidelines and compliance requirements
Prior experience resolving enrollment discrepancies and eligibility issues within a health plan environment
Candidates must live in Ventura County, Santa Barbara County, San Luis Obispo County, Monterey County or Santa Cruz County

Benefits

Comp & perks

Medical, dental & vision
Critical Illness, Accident, and Hospital coverage
401(k) Retirement Plan with pre-tax and Roth post-tax contributions
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)