- 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
- 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
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Customer Enrollment Representative
1 day ago
STAR ITERATIONS INC South Gate, United States**Star Iterations** is committed to helping underserved communities stay connected through the impactful outreach initiatives we implement across Los Angeles. We work together to deliver the most effective and compassionate customer service possible. We put a focus on assisting c ...
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Enrollment Representative
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Elite Marketing Strategies Inc Van Nuys, United StatesAt **Elite Marketing Strategies**, we connect local districts with the leading telecommunications technology available in our region. As an established yet continuously expanding firm, our strength lies in our ability to listen to the market and develop solutions for their changi ...
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Medicare Advantage Enrollment Representative
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UCLA Health Los Angeles, United States 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 ...
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Enrollment Representative
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Experiential Group Santa Ana, United StatesWe are seeking motivated individuals to join our team as an Enrollment Representative. For the right individual, we are willing to provide full in-house training from the initial entry level Enrollment Representative role as well as continued development and education to be able ...
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Enrollment Representative
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APR Consulting Irwindale, United States ContractAn energy and utilities client is looking for an Enrollment Representative who will process incoming orders, and receive, evaluate, and answer customer inquiries promptly. · Location: Irwindale, CA Hybrid) · Position: Enrollment Representative · Pay: $23/hr. on W2 · Duration: 12 ...
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Enrollment Representative
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APR Consulting Azusa, United StatesAn energy and utilities client is looking for an Enrollment Representative who will process incoming orders, and receive, evaluate, and answer customer inquiries promptly. · Location: Irwindale, CA Hybrid) · Position: Enrollment Representative · Pay: $23/hr. on W2 · Duration: 12 ...
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Outreach & Enrollment Representative
1 day ago
Family Health Care Centers of Greater Los Angeles Bell Gardens, United StatesOverview: · POSITION TITLE: Outreach & Enrollment Representative · DEPARTMENT: Outreach · REPORTS TO: Operations Manager · POSITION OVERVIEW: · The Outreach & Enrollment Representative shall be responsible to approach prospective patients in a linguistically and culturally s ...
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L.A. Care Health Plan Los Angeles, United States 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 ...
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L.A. Care Health Plan Los Angeles, United StatesSalary 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 ...
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L.A. Care Health Plan Los Angeles, United StatesSalary 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 ...
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Associate Enrollment Representative
1 day ago
Providence Service Anaheim, United StatesDescription · Working under the direction of the Manger, Enrollment, this position processes and updates monthly HMO member eligibility as received from health plans within established guidelines. · Providence caregivers are not simply valued – they're invaluable. Join our team a ...
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Wireless Agent
13 hours ago
Free Wireless Los Angeles, United StatesJoin our dynamic team as an Agent at Free Wireless, As an Agent, you will play a pivotal role in distributing free phones under the LifeLine & Affordable Connectivity Program (ACP). This position offers a competitive hourly rate, providing an exciting opportunity for motivated in ...
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Associate Registrar
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USC Los Angeles, United StatesThe Associate Registrar is primarily responsible for overseeing the law school's JD academic advising, bar exam administration resources and programming, and course scheduling systems. This position supports the law school's mission to recruit, retain, and graduate talented and d ...
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Case Manager
1 day ago
Abundant Blessings Los Angeles, United States**Case Manager (Homeless Services)** · **(ABUNDANT BLESSINGS)**: · - _______________________________ · **Title: Case Manager (Home Safe - Older Adults)** · **FLSA: Non-Exempt, Full-time (Monday-Friday)** · **Supervisor: Lead Case Manager** · **Starting Rate: $20.50 To DOE** · **B ...
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Music Instructor
2 days ago
Boys & Girls Clubs of Metro Los Angeles Los Angeles, United States: · **OVERVIEW** · The Music Instructor monitors and assesses the implementation of music programs and services; supports the development and implementation of new music programs. Represents the Music Department at various community relation activities and events and performs rel ...
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Membership Service Representative Ii
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YMCA of Metropolitan L.A. Los Angeles, United StatesThe YMCA of Metropolitan Los Angeles is not only the premiere non-profit in Los Angeles, it is also a great place to work, make a difference in your community and meet like-minded individuals. With twenty-six branches, three camps and over fifty child care sites, the LA Y is a hi ...
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Mat Navigator
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Patient Access Specialist
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Gracelight Community Health Los Angeles, United StatesThe Patient Access Specialist works under the direction of the Patient Access Manager. The PAS is responsible for ensuring internal and external clients are provided with exceptional customer service. The PAS is responsible for ensuring inbound and outbound calls are handled appr ...
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Human Resources Manager
2 days ago
Santa Monica Proper Los Angeles, United StatesSanta Monica Proper Hotel · Santa Monica Proper marries the elevated design of Kelly Wearstler with a 1920's landmark building and new contemporary architecture. There are 267 guest rooms and suites, many with terraces, embody the relaxed sophistication of the California lifestyl ...
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Valet Attendant
3 days ago
Towne Park Los Angeles, United States**Job Details** · differential. · **Work Schedule**: The work schedule for this position is Thursday to Monday. · **Paid Time Off**:Employees accrue hours of PTO per hour worked up to a maximum of 40 hours per calendar year. Employees accrue 0.02 hours of floating holiday per hou ...
Medicare Advantage Sr. Enrollment Representative - Los Angeles, United States - UCLA Health
Description
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:
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:
