Medicare Enrollment Specialist

Summary

Join the Central California Alliance for Health as a Medicare Enrollment Specialist and be a part of a dedicated team launching its first Medicare D-SNP. You will play a key role in facilitating the enrollment process, ensuring timely and accurate processing within the enrollment system. Collaborate with internal and external stakeholders to streamline enrollment activities and track member data. This position offers the unique opportunity to shape processes and establish best practices, contributing to an optimal customer experience. The ideal candidate is a self-starter with meticulous attention to detail and experience with Medicare enrollment processes and CMS guidelines. The position is in a hybrid work environment.

Requirements

• Is a self-starter
• Comfortable navigating ambiguity and works well with little direction
• Meticulously organized and has razor-sharp attention to detail
• Has experience with the Medicare enrollment process and familiarity with CMS guidelines and turnaround times related to enrollment
• Excellent interpersonal skills with emphasis on collaboration
• Knowledge of: The Medicare member enrollment process and related CMS requirements
• MHK Market Prominence Medicare Advantage member enrollment, billing, and financial reconciliation platform
• The methods and techniques of data entry
• The methods and techniques of system-generated reporting
• Windows-based PC systems, including Microsoft Word, Excel, Outlook and PowerPoint
• Ability to: Ensure that Medicare D-SNP enrollment activities comply with CMS and DHCS requirements
• Learn Medi-Cal program eligibility requirements and enrollment related regulations, the Medi-Cal Eligibility Data System (MEDS-Lite) and its HIPAA compliant portal
• Understand the interaction between Alliance systems and CMS systems
• Enter, proofread, verify, analyze, and audit data
• Produce organized, accurate, and detail-oriented work and maintain accurate records
• High School Diploma or equivalent
• A minimum of four years of experience performing Medicare member enrollments (an Associate’s degree may substitute for one year of the required experience); or an equivalent combination of education and experience may be qualifying

Responsibilities

• Facilitates the enrollment process into the Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) for those prospective dual-eligible beneficiaries by ensuring timely, compliant, and accurate enrollment processing within the enrollment and eligibility system
• Works with internal and external stakeholders to facilitate Medicare D-SNP enrollment activities
• Tracks and reports on prospective and current member enrollment data and performs other activities in support of the Medicare Operations Department’s enrollment function

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations