Medicare Enrollment Specialist

🔥 18 hours ago

⚔️ Virginia, West Virginia – Remote

⚔️ Virginia – Remote ⛰️ West Virginia – Remote

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 11%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Peak Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems.

📋 Description

• Analyze and process Medicare enrollment forms, checking validity, completion, and accuracy • Determine whether to enroll, conduct outreach, or reject applications according to organizational policies and procedures • Review and evaluate documents for quality control before final entry • Enter and verify member form data • Resolve enrollment issues to provide an efficient member experience • Maintain Medicare member enrollment records, including changes, updates, and outreach • Meet production and quality standards and maintain Workqueues • Communicate with internal and external staff • Escalate issues to the appropriate level of supervision • Manage coordination of benefits on member records • Develop and deliver department training to new hires • Participate in system testing for development rollouts • Participate in department planning for Open Enrollment • Process SNP applications and verify eligibility, including Dual-Entitlement and residence within the service area

🎯 Requirements

• High School diploma or equivalent • Either two (2) years of experience working with medical or institutional data entry and two (2) years of customer service experience, or one (1) year of Medicare eligibility and Medicare Enrollment processing experience • Familiarity with medical insurance enrollment processes • Working knowledge of administrative and clerical procedures and systems, including word processing and managing files and records • Ability to take direction and navigate multiple systems simultaneously • Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette skills • Ability to solve problems using predefined methods and guidelines • Exceptional attention to detail and ability to organize and perform multiple tasks simultaneously • Ability to sit for extended periods • Standard office environment experience with electrical equipment • Computer proficiency with Microsoft Office Professional Suite, Internet Explorer, and EPIC

🏖️ Benefits

• Full-time schedule of 40 hours per week