Medicare Advantage Sr. Enrollment Representative
3 weeks ago
General Information
Press space or enter keys to toggle section visibility
Work Location: Los Angeles, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday - Friday, 8:00am - 5:00pm PST
Posted Date
03/19/2024
Salary Range: $28.23 - 40.44 Hourly
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
14970
Primary Duties and Responsibilities
Press space or enter keys to toggle section visibility
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: $28.23 - $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.
Job Qualifications
Press space or enter keys to toggle section visibility
We'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 Sr. Enrollment Representative
4 weeks ago
Los Angeles, California, United States UCLA Health Full timeAs 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...
-
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
2 weeks ago
Los Angeles, United States University of California Full timeDescription As 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...
-
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...
-
Enrollment RN
2 weeks ago
Los Angeles, United States Seasoned Recruitment Full time$10,000 Sign-on Bonus! Purpose: The Enrollment RN is responsible for providing telephonic support and assistance for prospective members during the enrollment process. This role requires fluency in both English and Spanish in order to effectively communicate with bilingual members. Essential Responsibilities: Assist prospective members with the enrollment...
-
Enrollment RN
3 days ago
Los Angeles, United States Seasoned Recruitment Full time$10,000 Sign-on Bonus! Purpose: The Enrollment RN is responsible for providing telephonic support and assistance for prospective members during the enrollment process. This role requires fluency in both English and Spanish in order to effectively communicate with bilingual members. Essential Responsibilities: Assist prospective members with the enrollment...
-
Enrollment RN
3 weeks ago
Los Angeles, United States Seasoned Recruitment Full timeJob DescriptionJob Description$10,000 Sign-on Bonus!Purpose: The Enrollment RN is responsible for providing telephonic support and assistance for prospective members during the enrollment process. This role requires fluency in both English and Spanish in order to effectively communicate with bilingual members.Essential Responsibilities:Assist prospective...
-
Inside Sales and Retention Representative II
3 weeks ago
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (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...
-
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, United States L.A. Care Health Plan Full timeSalary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (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...
-
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, United States L.A. Care Health Plan Full timeSalary Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (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...
-
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...
-
Los Angeles, United States L.A. Care Health Plan Full timeSalary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (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...
-
Enrollment RN
16 hours ago
Los Angeles, CA, United States Seasoned Recruitment Full time$10,000 Sign-on Bonus!Purpose: The Enrollment RN is responsible for providing telephonic support and assistance for prospective members during the enrollment process. This role requires fluency in both English and Spanish in order to effectively communicate with bilingual members.Essential Responsibilities:Assist prospective members with the enrollment...
-
Los Angeles, United States CalWest Educators Placement Full timeApplicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. CalWest client school in Los Angeles seeks a Student Acquisition and Enrollment Specialist to begin July 1, 2024. Qualifications Bachelor degree in Education, Marketing, Communications, or related field...
-
Student Acquisition and Enrollment Specialist
4 weeks ago
Los Angeles, United States CalWest Educators Placement Full timeApplicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.CalWest client school in Los Angeles seeks a Student Acquisition and Enrollment Specialist to begin July 1, 2024.QualificationsBachelor degree in Education, Marketing, Communications, or related field3-5...
-
Sr. Collections Representative
1 week ago
Los Angeles, United States Siri InfoSolutions Inc Full timeJob DescriptionJob DescriptionTitle: Sr. Collections RepresentativeWorking Hours: 7:30 am - 4:30 pmLocation: Los Angeles CAAssignment length: 4+ months contract with possibility of extensionNotes:Minimum of 3 years of Hospital Collections within a hospital setting, with strong emphasis on Medi-Cal Managed Care contracts and appeals/underpayment collection...