Enrollment Specialist (ONSITE)

Job Title: Enrollment Specialist (Onsite - Hybrid Ability 2025)

Job Location Details:

Client Location: CA

Work Location: Orange, CA 92868

Job Description:

We are revolutionizing health care for seniors by leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

The Enrollment Representative is responsible for all new plan enrollments. Researching validating and reconciling enrollments from the error reports and CMS (Center for Medicare and Medicaid Services) daily files. Ensures all data entry is completed with the require time frame.

Responsibilities/ Job Duties:

• Sending correspondence to Members or CMS (Center for Medicare and Medicaid Services) to gather information or provide updates for corrections.
• Ensure the TRR is reviewed on a daily basis.
• Submit daily transaction files to CMS.
• Ensure that all enrollments, denials and rejects meet Medicare guidelines (Chapter 2 Medicare Advantage Enrollment and Disenrollment manual).
• All OEV letters are to be logged in the membership data base.
• Act as a liaison to the Sales Representatives. Ensure that new enrollments are processed properly. Provide any issues identified to the necessary internal department heads.
• Data entry of all enrollment applications as well as disenrollments into plan's data system.
• Track all pending enrollments for additional information needed for qualification.
• Assist in the departmental compliance tasks which include the Working Aged Survey Mailing, Annual Notice of Change Letter, Health Care Risk Assessment mailings, and all other necessary compliance mailings.
• Submit monthly reports to the Membership Manager, enrollment applications processed and returned, member appointments scheduled, and number of mailed packets and returned mail.

Minimum Education and Experience Requirements:

• 1+ years of experience in Healthcare Admin setting required.
• Prefer call center, insurance, MA experience.
• Call volume, healthcare terminology, Microsoft office/excel proficiencies

Schedule/ Shift: M-F, 8am-5pm or 9am-6pm **MAY be asked to work until 7pm or on SATs through the end of the year as OT. Must be able to meet business needs when OT is requested.

**Ability to go Hybrid 2x a week remote at the start of 2025.

Benefits:

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances)

• Health Benefits / Dental / Vision (Medix Offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s).)

• 401k (eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1)

• Short Term Disability Insurance

• Term Life Insurance Plan

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

About Medix?

Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.

Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for.

Join our network of talented professionals!

Medix is acting as an Employment Business in relation to this vacancy.