Description:

The Medicare Group Enrollment Specialist will be responsible for researching and processing complex reconciliations of Employer Group, Individual and Family, and Medicare Advantage accounts. This role involves resolving complicated issues related to compliance with State and Federal regulations, and coordinating benefits between Employer Group and Medicare Advantage plans. The specialist will create and implement processes related to compliance, group contracts, and other departmental value stream initiatives.

Key Responsibilities:

• Research and process complex reconciliations of various accounts including Employer Group, Individual and Family, and Medicare Advantage.

• Resolve issues pertaining to compliance with State and Federal regulations and coordination of benefits between Employer Group and Medicare Advantage.

• Create and implement processes related to compliance, group contracts, and departmental value stream initiatives.

• Identify, investigate, and document all revenue-based CMS status codes and beneficiaries, ensuring compliance with CMS regulations.

• Resolve discrepancies and prepare reports for management or Employer Groups.

• Process, track, and monitor CMS-related and Employer Group membership requests and actions.

• Ensure accurate coding of Medicare and Group coverage contracts and CMS-related/Employer Group data in the membership system.

Specific Duties:

• Enroll members of the Postal Service Health Benefit Board transitioning into the Medicare group.

• Look up coverage in MARx and enroll members based on the Postal Service reformate.

• Separate postal members from government members and ensure they are auto-moved over.

• Perform limited enrollment processing and make outbound calls as necessary.

• Work within a team of coordinators who are detail-oriented and think outside the box.

Qualifications:

• Strong understanding of State and Federal regulations related to Medicare and Employer Group benefits.

• Experience with CMS regulations and status codes.

• Proficiency in using MARx for coverage lookup and enrollment.

• Excellent problem-solving skills and attention to detail.

• Ability to work collaboratively within a team.

• 3-5 years of experience working in an administrative capacity

• Computer literacy with typing at 40 WPM

• Knowledge of database and MS Office applications, including Excel and Word.

Please apply with an updated resume!

We reserve the right to pay above or below the posted wage based on factors unrelated to sex, race, or any other protected classification.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. This temporary role may be eligible for the following:

• Medical, dental & vision

• 401(k)/Roth

• Insurance (Basic/Supplemental Life & AD&D)

• Short and long-term disability

• Health & Dependent Care Spending Accounts (HSA & DCFSA)

• Transportation benefits

• Employee Assistance Program

• Time Off/Leave (PTO, Vacation or Sick Leave)

  About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.