Medicare Advantage Sr. Enrollment Representative
4 weeks ago
As a member of the Medicare Advantage Operations team, the Senior Medicare Advantage Enrollment Representative plays a pivotal role in processing all enrollment, disenrollment, and cancellation requests.
This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ensure accurate and timely processing.
The ideal candidate will possess excellent communication skills and the ability to collaborate with various departments to address member issues promptly and implement ADHOC resolutions to sustain quality member care.
Responsibilities include:
- Ensure accurate completion of enrollments in accordance with CMS and other Managed Care Guidelines
- Process all Enrollment, Disenrollment, cancellation requests, reinstatements and managed retro reconciliation files or requests
- Reconcile daily Transaction Reply Report (TRR) and retro reconciliation files
- Maintain oversight on the accuracy and timeliness of acknowledgment notices sent to members
- Maintain open lines of communication with various departments to resolve member issues promptly and implement ADHOC resolutions to sustain quality member care
- Understand all aspects of enrollment operations, Medicare membership enrollment, reconciliation, and benefits coordination operations
- Hands-on experience with 834 EDI, State (CA DHS), and CMS files
Salary Range:
$ $40.44 Hourly
Note:
This posted position is 1 of 3 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.
QualificationsWe're seeking detail-oriented, self-directed professional with:
- High School Diploma or equivalent work experience required
- Required a minimum of three years' experience in a Medicare health plan or Managed Care - Enrollment, Disenrollment and Reconciliation
- Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements
- Initiative, problem identification, resolution and analytical skills are essential
- Excellent oral and written communication skills are required
- Ability to modify and adapt operational procedures to changing operational needs
- Ability to develop, implement, and evaluate methods and systems to improve efficiency
- Proven skills to lead and facilitate cross-functional workgroups and other meetings
- Ability to work as part of a team, collaborating with colleagues
- Ability to analyze and organize complex federal and private insurance regulations
- Ability to travel/attend off-site meetings and conferences
-
Medicare Advantage Enrollment Representative
4 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs a member of the Medicare Advantage Operations team, the Medicare Advantage Enrollment Representative plays a crucial role in the enrollment process by reviewing and submitting enrollment requests. This position requires meticulous attention to detail to ensure the accuracy and timeliness of acknowledgment notices sent to members. The ideal candidate will...
-
Medicare Advantage Premium Billing Analyst
4 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs a member of the Medicare Advantage Operations team, the Medicare Advantage Premium Billing Analyst plays a vital role in ensuring accurate and timely processing of payments, reconciliation of member accounts, and issuance of invoices. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to maintain the...
-
Inside Sales and Retention Representative II
3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $55, Min.) - $69, Mid.) - $82, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Patient Authorization Representative
4 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs a Patient Authorization Representative, you will be responsible for: Pre-encountering and pre-registering patients as well as providing registration support to patients, clinic staff, and managers Verifying insurance and enter insurance benefits information into the CareConnect system prior to appointments Determining co-pays and deductibles; confirming...
-
Sr. Member Service Officer
5 days ago
Los Angeles, California, United States First Entertainment Credit Union Full timeFirst Entertainment Credit Union is looking for a temporary Sr. Member Service Officer(Floater) responsible for delivering an excellent member service experience to its current and potential members. The Sr. Member Service Officer (Floater) is responsible for building member relationships through individual efforts by educating and advising members about...
-
Product Solutions Manager III
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $102, Min.) - $132, Mid.) - $163, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Inside Sales Representative Bilingual
2 weeks ago
Los Angeles, California, United States Saint-Gobain Full timeThe Inside Sales Representative will be responsible for leveraging customer engagement opportunities (leads) from both inbound and outbound interactions to identify, develop, document, and appropriately route sales opportunities to product sales teams throughout Saint-Gobain North America.Inside Sales Representatives will work in a team selling atmosphere...
-
Product Solutions Manager II
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88, Min.) - $115, Mid.) - $142, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Broker Services Specialist II
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $55, Min.) - $69, Mid.) - $82, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure...
-
Broker Services Specialist II
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $55, Min.) - $69, Mid.) - $82, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Claims Compliance Data Validation Analyst II
3 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $77, Min.) - $100, Mid.) - $123, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Claims Compliance Data Validation Analyst II
4 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $77, Min.) - $100, Mid.) - $123, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Director, Sales Strategy and Services
2 weeks ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $135, Min.) - $175, Mid.) - $216, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Product Solutions Manager III
5 hours ago
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $102, Min.) - $132, Mid.) - $163, Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan, serving more than 2 million members in five health plans to ensure...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $50, Min.) - $62, Mid.) - $75, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
-
Los Angeles, California, United States L.A. Care Health Plan Full timeSalary Range: $88, Min.) - $115, Mid.) - $142, Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make...
