Enrollment Specialist

Job Descripiton We are seeking a detail-oriented Health Plan Enrollment Representative to support enrollment operations for a leading healthcare organization. In this role, you will be responsible for preparing, processing, uploading, and maintaining member and group registration information within our enrollment databases. You will act as a key liaison, communicating with brokers, customers, vendors, and internal Member Services teams to ensure accurate enrollment, resolve file issues, and maintain high standards of regulatory compliance and data integrity. (Note: All necessary computer equipment for this role will be provided by the employer). Key Responsibilities Process and enter new enrollments, terminations, demographic updates, and Primary Care Physician (PCP) changes. Verify eligibility status, analyze transactional data, and resolve eligibility discrepancies. Submit and process retroactive eligibility changes as needed. Respond to eligibility inquiries and communicate effectively with brokers, customers, vendors, and internal teams to obtain missing information. Review enrollment submissions for accuracy, generate member correspondence, and process duplicate ID card requests. Support data audits, inventory control, and open/annual enrollment readiness with cross-functional teams. Strictly adhere to regulatory compliance standards, production standards, and PHI (Protected Health Information) protection protocols. Required Qualifications High School diploma or equivalent education/experience. 1+ year of recent, relevant experience in health plan enrollment, eligibility, insurance, or healthcare operations. Proven experience handling member/group enrollment, terminations, demographic updates, PCP changes, and eligibility verification. Experience reconciling discrepancies, reviewing pending enrollment data, and processing retroactive changes. Proficiency in Microsoft Office Suite (Excel, Word, and PowerPoint). Experience with database management, data validation, enrollment system uploads, and file layouts. strong understanding of PHI confidentiality and ability to follow audit controls and regulatory requirements.

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

Responsibilities

Process and enter new enrollments, terminations, demographic updates, and Primary Care Physician (PCP) changes.
Verify eligibility status, analyze transactional data, and resolve eligibility discrepancies.
Submit and process retroactive eligibility changes as needed.
Respond to eligibility inquiries and communicate effectively with brokers, customers, vendors, and internal teams to obtain missing information.
Review enrollment submissions for accuracy, generate member correspondence, and process duplicate ID card requests.
Support data audits, inventory control, and open/annual enrollment readiness with cross-functional teams.
Strictly adhere to regulatory compliance standards, production standards, and PHI (Protected Health Information) protection protocols.

Skills

• attention to detail
• time management
• project coordination

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 randstadusa.com.

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.