Job Title: Enrollment Representative

Position Summary: The Enrollment Representative is responsible for accurately processing, reviewing, and updating enrollment applications for Medicare Advantage Plans in compliance with CMS guidelines and company policies. This role requires strong attention to detail, excellent communication skills, and the ability to meet high productivity and accuracy standards in a fast-paced environment.

Responsibilities / Job Duties

• Accurately, enter, review, and update enrollment applications
• Verify applicant eligibility for Medicare Advantage Plans, ensuring compliance with CMS guidelines
• Review applications for completeness, required documents, and accuracy before submission
• Process plan changes, denials, and special election request as applicable
• Maintain up-to-date knowledge of CMS enrollment guidelines, HIPAA requirements, and company policies
• Identify, document, and escalate enrolment discrepancies or errors in accordance with compliance protocols
• Perform qualify check on one’s own work to meet accuracy metrics
• Respond to internal inquiries from agents, brokers, and customer service teams regarding enrollment status
• Provide clear, professional communication to resolve application issues in a timely manner
• Collaborate with internal departments to ensure prompt resolution of enrollment-related issues
• Consistently meet or exceed productivity, accurate, and timeliness goals for enrollment processing (metrics =  processing 80-110 applications, about 8-10/hour, they will ramp them to this)
• Track daily work volumes, turnaround times, and error rates in line with department performance standards
• Accurately, enter, review, and update enrollment applications
• Verify applicant eligibility for Medicare Advantage Plans, ensuring compliance with CMS guidelines
• Review applications for completeness, required documents, and accuracy before submission
• Process plan changes, denials, and special election request as applicable
• Maintain up-to-date knowledge of CMS enrollment guidelines, HIPAA requirements, and company policies
• Identify, document, and escalate enrolment discrepancies or errors in accordance with compliance protocols
• Perform qualify check on one’s own work to meet accuracy metrics
• Respond to internal inquiries from agents, brokers, and customer service teams regarding enrollment status
• Provide clear, professional communication to resolve application issues in a timely manner
• Collaborate with internal departments to ensure prompt resolution of enrollment-related issues
• Consistently meet or exceed productivity, accurate, and timeliness goals for enrollment processing (metrics =  processing 80-110 applications, about 8-10/hour, they will ramp them to this)
• Track daily work volumes, turnaround times, and error rates in line with department performance standards

Requirements:

• High school diploma, GED, or transcripts
• Minimum 1 year of data entry experience with strong business or office skills 
• Administrative experience in a healthcare setting highly preferred.
• Computer proficient

Schedule / Shift

• Mon-Fri (9am-6pm), some Saturdayas
• Overtime will be required

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 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.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.