Senior Enrollment Specialist

Location: Remote, United States

Salary: $50,000–$56,000 annual US base salary

Company

hirify.global and UST HealthProof provide AI-powered, cloud-based operational infrastructure and core administration solutions for health insurance companies, including business process-as-a-service operations.

What you will do

• Prepare, process, and maintain enrollment and disenrollment requests.
• Verify eligibility requirements, review Medicaid eligibility, and complete verification processes.
• Review and process CMS transactions and resolve enrollment system rejections according to regulatory and client guidelines.
• Reconcile membership reports and enrollment-related data, including billing discrepancies.
• Build case files for CMS Contractor approval and resolution.
• Mentor junior team members, support quality reviews and training, and collaborate on process documentation and special projects.

Requirements

• 5+ years of professional experience processing Medicare enrollment transactions.
• Thorough understanding of Medicare Advantage products, CMS transaction files, and enrollment guidelines.
• Experience with CMS interfaces and systems used for Medicare Advantage enrollment and billing.
• Ability to analyze enrollment reconciliation data, report SLAs and KPIs, and present findings in a structured way.
• High school degree required.
• Strong collaboration, adaptability, learning ability, and work ethic.

Culture & Benefits

• Full-time, permanent employment in a remote US work environment.
• Work across multiple time zones using computer and video technology.
• Training is provided by the client and employer.
• Occasional travel may be required based on company needs.
• Reasonable accommodations are available in accordance with the Americans with Disabilities Act.