Enrollment Service Rep

8:00 am – 5:00 pm, 40 hours per week.

About the role

The Medicare Enrollment Representative is responsible for timely processing of enrollment and disenrollment requests using CMS guidelines and policies. They ensure the timely completion of all correspondence and reporting functions associated with the Medicare Enrollment Unit and understand how enrollment functions affect other Plan Units and Departments. The role also provides Sales Support as needed during peak sales periods.

Responsibilities

• Communicate with current and prospective members professionally, accurately, and thoroughly.
• Answer prospective sales phone line and route calls to appropriate licensed Sales staff.
• Record all calls accurately in the Customer Service Module or Medicare Call Log.
• Complete a variety of enrollment and disenrollment functions.
• Understand how the Enrollment area functions affect other units and departments.
• Assist with the completion of a variety of reports in accordance with CMS requirements and guidelines (e.g., TRR, BEQs, and EDVs).
• Process correspondence.
• Report all suspicious issues to the Compliance Department or Departmental Manager.
• Keep all former, current, or prospective members’ (and other employees’) Protected Health Information (PHI) confidential.
• Work overtime if required to meet CMS timeliness requirements.
• Participate in external and/or internal trainings as required.
• Consistently display a positive attitude and maintain acceptable attendance.
• Assist with lobby traffic for current and prospective members with Enrollment/Disenrollment questions and concerns.

Requirements

• High School Diploma (required).
• Typing and computer skills.
• Good telephone and communication skills.
• Self-starter, detail-oriented, with the ability to prioritize and meet deadlines.
• Ability to maintain confidentiality.
• Mathematical skills.
• Good work ethic (e.g., adequate learning skills, even temperament, ability to follow instructions, retains information, works well with others).
• Ability to adapt easily to changes in work requirements.

Qualifications

• Familiarity with Medicare Enrollment and Disenrollment processes (desired).
• Knowledge of medical terminology (desired).
• Familiarity with CMS Regulations and Guidelines (desired).
• Knowledge of CPT, ICD-9, and ICD-10 coding (desired).