Sr Medicare Enrollment Processor

TITLE: Sr Medicare Enrollment Processor

TYPE: Contract

LOCATION: Philadelphia, PA

ONSITE/REMOTE/HYBRID: Onsite

START DATE: October 2024

SHIFT: Day

We are looking for a Sr Medicare Enrollment Processor. The Senior Medicare Enrollment Processor plays a crucial role in managing the enrollment processes efficiently and accurately. This position is responsible for handling enrollment applications, terminations, cancellations, and modifications in eligibility with precision and timeliness.

Main Responsibilities

• Efficiently process enrollment applications, disenrollments, cancellations, and eligibility updates.
• Ensure compliance with CMS guidelines, including the timely mailing of required materials.
• Handle Transaction Reply Reports from CMS and address related inquiries effectively.
• Conduct daily, weekly, and monthly reconciliations and support the Enrollment Team's operations.
• Troubleshoot system issues, offering solutions and recommendations concerning the enrollment process.
• Undertake special projects, perform thorough reconciliations, and manage escalations related to enrollment.
• Foster a team-oriented work environment while working independently when necessary.
• Ensure data integrity of enrollment records and manage complex enrollment issues, recommending process improvements.
• Develop, coordinate, and deliver training programs for Med D Enrollment staff, enhancing performance and recognition.
• Commit to corporate goals and mission, performing additional duties as necessary to achieve departmental and Plan objectives.
  
  

Qualifications

• High School diploma/GED required.
• 3 to 5 years of Enrollment Experience, preferably in Medicare or Managed Care Enrollment (MA, MAPD, PDP).
• Proficient in Microsoft Office (Excel, Access, Word, Outlook) and familiar with Medicare regulations, CMS, BAE, LEP, LIS, and MMP Plans.
• Proven ability to conduct advanced billing/enrollment research and identify and solve problems effectively.
• Experience in quality assurance and monitoring within an enrollment operations setting is desirable.
• Knowledge of quality procedures, policy and procedure documentation, and quality reporting.
• Excellent organizational, communication, and interpersonal skills are essential.
• Demonstrated ability to multitask in a fast-paced, deadline-driven environment while maintaining high accuracy in work.
• Experience in data management, eligibility, and enrollment complaint handling.
• Ability to develop and implement effective training and performance enhancement methods.
  
  

EOE STATEMENT

We are an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law