Enrollment Specialist

Job Description

Job Description

POSITION SUMMARY  

Responsible for the processing of new enrollment applications and updating current member profile changes in accordance with CMS and State regulations. 

ESSENTIAL DUTIES & RESPONSIBILITIES 

• Handles receiving, controlling, and processing enrollment and disenrollment elections from Medicare beneficiaries, as well as any required updates to a member record.  

• Audits data entered into the plans internal systems to ensure data integrity and quality.  

• Uses judgment and informed decision-making to determine appropriate actions on elections and in handling discrepancies. 

• Transmits election information to CMS within specified timeframes and according to CMS regulations. 

• Ensures appropriate letters are sent to members within CMS timeframes. 

• Conducts outbound calls to confirm and verify mailing addresses, permanent residency. 

• Sorts returned mail and prepares mail with corrected addresses.  

• Analyzes and interprets out of area indicator reports submitted by CMS and determine action to be taken.  

• Places materials into storage receptacles, such as file cabinets, boxes, bins, or drawers, according to classification and identification information.  

• Reads and scans all incoming materials to determine how and where they should be classified or filed.