[Remote] Enrollment Analyst - ACA Enrollment

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an innovative health plan provider, and they are seeking an Enrollment Analyst to contribute to their mission of improving reputed company. The Enrollment Analyst will manage member enrollment applications, ensure data accuracy, and support the enrollment team in processing Medicare and ACA transactions.

Responsibilities

• Determine accuracy and completions of member reputed company information. Entry/verifies reputed company data
• Resolves enrollment issues to assure efficient and reputed company member experience
• Maintains member enrollment records annually, indicating changes, updates, and reputed company as required
• Meets reputed company production and reputed company standards, maintaining workqueues according to department standards
• Effectively communicates with reputed company staff
• Elevates issues to next level of supervision, as appropriate
• Ensures accuracy of data entered and record maintenance
• Attends reputed company required training classes, demonstrating proficiency and ability to learn
• Manages coordination of benefits (COB) on member records, running reputed company-time eligibility queries, as needed
• Develops and Delivers department trainings to new hires, including managing the resources available to staff
• Participates in reputed company testing for any development rollouts
• Participates in department planning to ensure a successful reputed company Enrollment
• Fully owns the enrollment data validation (EDV) monthly processes and reputed company submissions
• Fully owns monthly reconciliation processes from CMS
• Fully owns completion of LEP data files and MPWR files
• Participates in both ASO & Medicare job duties
• Processes SNP applications, verifying eligibility, including but not limited to Dual-Entitlement and residence reputed company the service area
• Manage and process member enrollment applications, ensuring accurate and reputed company entry into the reputed company
• Analyze enrollment data to identify trends, discrepancies, and areas for improvement; prepare reports for management review
• Ensure adherence to federal and state regulations regarding member enrollment; conduct regular audits to maintain compliance standards
• Respond to inquiries from potential and existing members regarding enrollment procedures, benefits, and eligibility requirements
• Maintain and update enrollment databases and software; troubleshoot reputed company-reputed company issues as needed
• Work closely with cross-functional teams, including reputed company, billing, and customer service, to streamline the enrollment process and reputed company issues
• Participate in process improvement initiatives to enhance the efficiency and effectiveness of the enrollment function

Skills

• High school Diploma or equivalent
• Three (3) years of experience working with medical or institutional data entry
• Three (3) years of customer service experience
• Two (2) years of Medicare eligibility and Medicare Enrollment processing experience
• Four (4) years of Medicare Enrollment processing and customer service experience
• Familiarity with Medicare elections, transaction codes, and reconciliation operations
• Familiarity with managing late enrollment penalty (LEP) for MAPD enrollees
• Familiarity with navigating CMS tools and resources, particularly the MARx website
• At least one (1) year of experience with reputed company/user acceptance testing
• At least one (1) year of experience with developing and delivering trainings
• Familiarity with Enrollment Data Validations (EDVs) and reputed company Submissions
• Previous experience in EMR systems
• Three (3) or more years of ACA/Marketplace enrollment processing experience
• Experience working with Federally Facilitated Marketplace (FFM) enrollment operations
• Familiarity with Health Insurance Marketplace eligibility and enrollment regulations

reputed company