Enrollment Representative

Salary: USD
21 - USD
21 per hour + Medical, Vision, Dental, Weekly Pay, Sick Pay

The Enrollment Representative is responsible for processing all new Medicare Advantage plan enrollments, ensuring high attention to detail and accurate data entry within required time frames. In this role, you will review applications, verify eligibility under CMS guidelines, and collaborate with internal teams to resolve issues. While primarily a data-driven entry role, you will occasionally make outbound calls to gather missing information.

This position offers a great entry point into a rapidly growing Health Plan with cross-training opportunities, potential for extension or permanent placement, and a hybrid work option after initial training.

• Accurately enter, review, and update enrollment applications in a timely manner.
• Verify applicant eligibility for Medicare Advantage Plans, ensuring strict compliance with CMS guidelines and HIPAA requirements.
• Review applications for completeness, required documentation, and accuracy prior to submission.
• Process plan changes, denials, and special election requests as applicable.
• Identify, document, and escalation enrollment discrepancies or errors following compliance protocols.
• Perform quality checks on individual work to meet established accuracy metrics.
• Maintain up-to-date knowledge of CMS enrollment guidelines and company policies.
• Respond to internal inquiries from agents, brokers, and customer service teams regarding enrollment status.
• Provide clear, professional communication to resolve application issues promptly.
• Collaborate with internal departments to ensure efficient resolution of enrollment-related issues.
• Consistently meet or exceed productivity, accuracy, and timeliness goals (processing 80–110 applications daily, or ~8–10 per hour after ramp-up).
• Track daily work volumes, turnaround times, and error rates in line with department performance standards.
• Make occasional outbound phone calls to applicants or partners to obtain missing information as needed.

• High school diploma, GED, or official transcripts.
• 1+ years of data entry experience with strong general business/office skills (healthcare experience is not required).
• Computer proficiency, including basic computer literacy.
• Comfort with occasionally making outbound phone calls.
• Strong attention to detail, reliability, and a metrics-driven mindset.

• Prior experience in a Healthcare Administrative setting (e.g., call center, data entry, health insurance, or Medicare Advantage experience).

Standard Shift: Monday – Friday, 9:00 AM – 6:00 PM.

Location Structure: Onsite during the initial 4-week training period (located in Orange, CA). Potential to transition to a hybrid schedule (3 days onsite / 2 days remote) post-training.

Overtime: Overtime is required based on business needs. Candidates must be flexible to work shifts between 8:00 AM – 8:00 PM Monday through Friday, as well as occasional Saturdays (no Sunday work).

$21.00 – $22.00 / hour

Weekly Pay, Medical, Dental, Vision, Short Term Disability, and Life Insurance