Medicare Advantage Enrollment Representative

2 weeks ago


Somerville, Massachusetts, United States Mass General Brigham Health Plan Full time
Job Title: Medicare Advantage Enrollment Representative

Join Mass General Brigham Health Plan as a Medicare Advantage Enrollment Representative and play a critical role in ensuring the smooth enrollment process for our Medicare members. As a key member of our Member Enrollment Team, you will be responsible for accurately processing enrollment information, resolving discrepancies, and providing exceptional customer service to our internal and external clients.

Key Responsibilities:
  • Process enrollment information for Medicare members, ensuring accuracy and completeness
  • Resolve discrepancies and issues related to enrollment, billing, and eligibility
  • Provide exceptional customer service to internal and external clients, including IT, Customer Services, Sales, Claims, Product, and Finance teams
  • Assist with monthly reconciliation and special projects as needed
  • Research and resolve billing issues, ensuring timely and accurate payment
  • Trigger letters to members and ensure accurate data for all members
  • Oversee enrollment processes in the absence of direct supervisor
  • Navigate various systems (QNXT, EAM, MERP, etc.) to resolve member issues
  • Understand the distinction between different lines of business (Medicare, Commercial, MassHealth)
  • Meet or exceed daily productivity goals and monthly QC goals
  • Act as a back-up to specific job functions in the department, such as troubleshooting reports
  • Participate in team meetings and facilitate in the absence of Supervisor
  • Assist less experienced staff with complex issues and provide training as needed
Requirements:
  • High School diploma or equivalent required; 3 years of related health plan experience preferred
  • Enrollment experience with a Medicare Advantage product highly preferred
  • Excel/reporting background
  • College degree preferred
  • Demonstrate Mass General Brigham Health Plan's core brand principles, including always listening, challenging conventions, and providing value

Mass General Brigham Health Plan is an Equal Opportunity Employer. We are committed to creating a diverse and inclusive work environment that values and respects all employees. We welcome applications from qualified candidates who share our values and are passionate about delivering exceptional patient care and service.



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