Enrollment Specialist (Healthcare)

Job Summary

We are seeking a detail-oriented Enrollment Specialist (Healthcare) for a temporary contract opportunity in San Juan, PR. This role supports enrollment operations within the healthcare insurance industry, with a focus on accurate application processing, eligibility verification, compliance, and member data integrity.

This is a strong opportunity for a healthcare insurance professional who enjoys structured processes, regulatory accuracy, and working with cross-functional teams to resolve member enrollment issues. The environment is fast-paced, collaborative, and service-focused, offering the chance to contribute to timely and accurate healthcare coverage administration while working with supportive teams and established procedures.

Key Responsibilities

- Process enrollment, disenrollment, and coverage change applications within required regulatory timelines.
- Review enrollment documentation for accuracy, completeness, and compliance with federal, state, and internal guidelines.
- Determined member eligibility and maintained accurate records through data updates and corrections.
- Identify incomplete cases, initiate follow-ups, and coordinate issue resolution with internal departments.
- Validate pending case reports and monitor special cases, including LEP, M3P, and ADI requirements.
- Manage PCP assignments and changes, resolve data discrepancies, and support corrections related to capitation or payment accuracy.

Compensation and Benefits

- Pay Rate: $13.00 per hour.
- Schedule: Monday to Friday, 8:00 AM to 4:30 PM.
- Location: San Juan, PR.
- Job Type: Temporary contract.

Equal Opportunity Employer / Disabled / Protected Veterans

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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications 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.

Additional Skills

Requirements

- High School Diploma or equivalent required.
- 2+ years of experience in enrollment processes within the healthcare insurance industry.
- Proficiency in Microsoft Office, including Excel, Word, and Outlook.
- Bilingual English and Spanish skills required.
- Strong analytical, organizational, and problem-solving abilities.
- Ability to manage multiple priorities, meet deadlines, and maintain accuracy in a fast-paced environment.
- Strong attention to detail and ability to work with sensitive member eligibility information.