Role OverviewThe Enrollment Reconciliation Specialist provides advanced operational oversight of Medicare D-SNP enrollment reconciliation and CMS/MARx transactions. This role is responsible for identifying, researching, and resolving complex enrollment discrepancies that may impact member eligibility, claims, pharmacy, accumulations, and regulatory reporting.
What You Will Do
Identify and investigate discrepancies between CMS/MARx internal enrollment systems, and downstream systems. Research root causes of enrollment discrepancies and develop appropriate corrective actions.
Why It Might Be a Fit
The successful candidate will have strong knowledge of CMS/MARx enrollment processes, experience working with Medicare Advantage and D-SNP/Medicaid populations, and advanced Excel and data-reconciliation skills.
Requirements
- High school diploma or equivalent
- Minimum of 3 years of healthcare enrollment, Medicare Advantage, D-SNP, membership, reconciliation, or health plan operations experience
- Strong knowledge of CMS/MARx enrollment processes
- Experience working with Medicare Advantage and preferably D-SNP/Medicaid populations
- Advanced Excel and data-reconciliation skills
Benefits
- Low-cost medical, dental, drug, and vision insurance
- Paid time-off
- 401k employer contribution
- Referral bonus
- Pretax transportation and parking program
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