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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates proficiency in Medicare Enrollment Processing, including analyzing and verifying enrollment forms, maintaining accurate records, and resolving enrollment issues. Strong communication and organizational skills are essential for effective collaboration and training within the department.
Highest-signal resume keywords
Medicare Enrollment ProcessingData Entry AccuracyCustomer Service ExperienceTraining Development and DeliveryFamiliarity with CMS Tools
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 Eligibility VerificationQuality ControlDocument EvaluationCoordination of Benefits (COB)System/User Acceptance TestingMedicare Elections ManagementLate Enrollment Penalty (LEP) ManagementAdministrative ProceduresMedical Insurance Enrollment Processes
Soft Skills
Effective CommunicationProblem-SolvingAttention to DetailOrganizational SkillsInterpersonal Skills
Tools & Technologies
Microsoft Office Professional SuiteInternet ExplorerEPICMARx Website
Industry Keywords
MedicareEnrollment FormsCustomer ServiceHealthcareOpen Enrollment
About the role
Key responsibilities & impact- Report to the Enrollment Manager
- 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 and final entry of member enrollment forms
- Determine accuracy and completeness of member form information; enter and verify form data
- Resolve enrollment issues to ensure an efficient and seamless member experience
- Maintain Medicare member enrollment records, including changes, updates, and outreach
- Meet production and quality standards and maintain Workqueues according to department standards
- Communicate effectively with internal and external staff
- Escalate issues to the appropriate level of supervision
- Ensure accuracy of data entry and record maintenance
- Attend required training classes and demonstrate proficiency
- Manage coordination of benefits (COB) on member records
- Develop and deliver department training to new hires
- Participate in system testing for development rollouts
- Participate in department planning for a successful Open Enrollment
- Process SNP applications and verify eligibility, including Dual-Entitlement and residence within the service area
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 a 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 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 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
- Proficiency with Microsoft Office Professional Suite (Outlook, Word, Excel, Access), Internet Explorer, and EPIC