Sr. Enrollment Representative

Job Description

Software Guidance & Assistance, Inc., (SGA), is searching for a Sr. Enrollment Representative for a Contract assignment with one of our premier Healthcare clients in a Remote Role.

Responsibilities :

• This role's responsibilities include but are not limited to: Understanding all aspects of Enrollment Operations, Medicare Membership Enrollment, Reconciliation, and benefits coordination operations.

Required Skills:

• High School Diploma or equivalent. Required
• Minimum of three to five (3-5) years' experience in a Medicare health plan or Managed Care – Enrollment, Disenrollment and Reconciliation - Required.
• Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements.
• Working knowledge of Microsoft Office Suite (Excel, Word, and PowerPoint) and data visualization tools.
• Skill in prioritizing and performing a variety of duties within a system that has frequently changing assignments, priorities and deadlines.
• Strong knowledge of the health care model and other managed care MSO operations.
• Strong critical thinking and the ability to apply knowledge at a broad level is essential.
• Reliability and compliance with scheduling standards.

Preferred Skills:

• The ideal candidate will have experience with 834 EDI, State (CA DHS) and CMS files.
• Highly desired experience includes the following - Managed Care experience - Medicare and Medicaid enrollment, business analysis and process improvement.