Join a rapidly growing Health Plan dedicated to improving care for seniors through Medicare Advantage plans! We are seeking detail-oriented, metrics-driven Enrollment Representatives to join our team on-site in Orange, CA. This position plays a critical role in processing new plan enrollments and ensuring high data accuracy while adhering to CMS guidelines.
This role offers cross-training opportunities, potential for permanent placement, and competitive overtime pay.
Enrollment Processing: Accurately enter, review, and update Medicare Advantage Plan enrollment applications.
Compliance & Verification: Verify applicant eligibility for Medicare Advantage Plans and ensure strict compliance with CMS guidelines and HIPAA requirements.
Document Review: Examine applications for completeness, required documentation, and accuracy prior to final submission.
Application Lifecycle Management: Process plan changes, denials, and special election requests as needed.
Discrepancy Escalation: Perform quality checks on your own work to meet accuracy standards and escalate application discrepancies/errors per compliance protocols.
Cross-Department Collaboration: Respond to inquiries from internal teams, agents, and brokers regarding enrollment status, resolving issues in a prompt and professional manner.
Outbound Outreach: While the primary focus is data entry, make occasional outbound calls to obtain missing information from applicants.
Performance Targets: Consistently meet or exceed department productivity, accuracy, and timeliness goals (processing 80-110 applications per day, or ~8-10 per hour once fully ramped).
Tracking: Log daily work volumes, turnaround times, and error rates according to performance standards.
High School Diploma, GED, or official transcripts.
1+ years of data entry experience with strong general business/office skills (healthcare background not required).
Proficiency with computer applications and digital tools.
Ability and comfort with making occasional outbound phone calls.
Strong attention to detail, reliability, and excellent attendance.
Background in a healthcare administrative setting (e.g., call center, data entry, health insurance, or Medicare Advantage experience).
Work Location: 100% On-site (Orange, CA).
Standard Hours: Monday - Friday, 9:00 AM - 6:00 PM.
Training Period: 4 weeks of full-time, classroom-style training with weekly knowledge checks and quizzes.
Overtime Requirements: Post-training overtime is required based on peak business volume. Candidates must be open to working 8:00 AM - 8:00 PM (Monday-Friday) and occasional Saturdays. Expected total hours range between 40-60 hours/week (No work on Sundays).
Blackout Period: Zero time off will be granted from your start date through December 15th due to mandatory training and annual enrollment peak volume.
Pay Rate: $21.00 per hour
Overtime: Ample overtime opportunities available during peak season.
Career Growth: Cross-training provided with opportunity to transition to a permanent role.
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
