Enrollment specialist

Summary / Duties: Health Plan Enrollment Representative supports Health Plan enrollment operations by preparing, processing, uploading, and maintaining member and group registration information in enrollment databases. Responsibilities include entering new enrollments and terminations, updating demographic and PCP information, verifying eligibility status, resolving discrepancies, analyzing transactional data, and submitting retroactive eligibility changes when needed. This role responds to eligibility inquiries, generates member correspondence, processes duplicate ID card requests, reviews enrollment submissions for accuracy, and communicates with brokers, customers, vendors, Member Services, and internal teams to obtain missing information or resolve file issues. The representative also supports data audits, inventory control, regulatory compliance, PHI protection, and open or annual enrollment readiness. Requirements: HS diploma or equivalent education/experience 1+ year recent relevant experience in health plan enrollment, eligibility, insurance, or healthcare operations Experience with member/group enrollment, terminations, demographic updates, PCP changes, and eligibility verification Experience reconciling eligibility discrepancies, reviewing pending enrollment data, and processing retroactive eligibility changes Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint Experience with database management, data validation, enrollment system uploads, and file layouts Ability to maintain PHI confidentiality and follow audit controls, production standards, and regulatory requirements Ability to communicate with brokers, customers, vendors, internal teams, and Member Services to resolve enrollment issues

salary: $25.59 - $25.6 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

Experience with member/group enrollment, terminations, demographic updates, PCP changes, and eligibility verification
Experience reconciling eligibility discrepancies, reviewing pending enrollment data, and processing retroactive eligibility changes
Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint
Experience with database management, data validation, enrollment system uploads, and file layouts

Skills

• insurance
• healthcare operations
• enrollment

Qualifications

• Years of experience: 1 year
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.


Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.


We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.