Enrollment Specialist

Job Description

Title : Enrollment Specialist

Location : Sioux Falls, SD

Job Type : 3 month contract (October 2026 - January 2027)

Compensation : $20.00 - $23.00 per hour (W2)

Industry: Health Insurance


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About the Role
Our client is a leading regional healthcare insurance organization dedicated to helping individuals, families, employers, and Medicare members access quality, affordable healthcare coverage. On their behalf, we are seeking an Enrollment Specialist to support membership operations, enrollment accuracy, and regulatory compliance. This role is ideal for a detail-oriented professional who enjoys working with data, regulations, and cross-functional teams to ensure an exceptional member experience. Job Description
The Enrollment Specialist is responsible for maintaining accurate member enrollment data, supporting membership retention and growth, and ensuring compliance with federal and state healthcare regulations. This position plays a critical role in enrollment operations by monitoring data transactions, resolving discrepancies, auditing records, and ensuring accurate member and group setup for claims processing and billing.

Key Responsibilities:

• Update and maintain enrollment and membership data in accordance with established policies, procedures, and regulatory requirements.
• Ensure compliance with HIPAA, COBRA, Medicare Secondary Payer (MSP) rules, CMS guidelines, and other applicable regulations.
• Monitor and process daily, weekly, and monthly enrollment transaction files received from government agencies, vendors, employers, and other partners.
• Oversee enrollment activities managed by delegated vendors, including member additions, changes, terminations, and ID card processing.
• Download, log, and maintain electronic enrollment files across multiple lines of business.
• Reconcile enrollment data, identify discrepancies, and implement corrective actions to improve data accuracy and operational performance.
• Audit enrollment records to ensure data integrity and compliance with organizational and regulatory standards.
• Collect and transmit enrollment and disenrollment data required by the Centers for Medicare & Medicaid Services (CMS).
• Ensure accurate setup and maintenance of member and group information to support claims administration and premium billing.
• Research, track, and resolve enrollment errors while identifying trends and root causes.
• Process eligibility exceptions and resolve electronic enrollment file discrepancies.
• Collaborate effectively with internal teams and external partners to support membership operations.

Qualifications

Required

• High school diploma or GED equivalent.
• 1-3 years of related administrative, enrollment, insurance, customer service, healthcare operations, or data management experience; or an equivalent combination of education and experience.
• Strong attention to detail and ability to maintain accurate records.
• Ability to interpret and apply policies, procedures, and regulatory requirements.
• Strong analytical and problem-solving skills.
• Proficiency with computer systems, databases, and Microsoft Office applications.
• Excellent written and verbal communication skills.
• Ability to work independently and collaboratively in a team environment.
• Commitment to maintaining confidentiality and handling sensitive information appropriately.

Preferred

• Experience working in the health insurance industry.
• Knowledge of healthcare enrollment processes and eligibility management.
• Familiarity with HIPAA, COBRA, CMS regulations, Medicare enrollment, and coordination of benefits processes.
• Experience performing audits, reconciliations, and data quality assurance activities.
• Experience working with enrollment, claims, or membership administration systems.
• Understanding of federal and state healthcare regulations affecting health plan operations.

Benefits
Dahl Consulting is proud to offer a comprehensive benefits package to eligible employees that will allow you to choose the best coverage to meet your family's needs. For details, please review the DAHL Benefits Summary: How to Apply
Take the first step on your new career path!To submit yourself for consideration for this role, simply click the apply button and complete our mobile-friendly online application. Once we've reviewed your application details, a recruiter will reach out to you with next steps! Equal Opportunity Statement
As an equal opportunity employer, Dahl Consulting welcomes candidates of all backgrounds and experiences to apply. If this position sounds like the right opportunity for you, we encourage you to take the next step and connect with us. We look forward to meeting you!


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Dahl Consulting is proud to offer a comprehensive benefits package to eligible contract employees that will allow you to choose the best coverage to meet your family's needs. For details, please review our Benefits Summary:


Dahl Consulting is an Equal Opportunity Employer and does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other applicable legally protected characteristics.


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