Enrollment Specialist II

Location: Remote, United States

Annual base salary: $40,000–$44,000

Company

hirify.global provides AI-powered operational infrastructure for health insurance companies, helping health plans modernize operations and improve financial performance.

What you will do

• Prepare, process, and maintain enrollment and disenrollment requests.
• Verify eligibility requirements and process CMS transactions.
• Review Medicaid eligibility and complete verification procedures.
• Resolve enrollment system rejections and reconcile membership reports according to CMS and client guidelines.
• Build case files for submission to CMS contractors and maintain accurate enrollment and billing records.
• Mentor junior team members and contribute to documentation, training, quality reviews, and other assigned projects.

Requirements

• High school diploma.
• 3–5 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 manner.
• Must be available to work remotely from the United States.

Nice to have

• Medicaid enrollment experience.
• Experience mentoring team members or contributing to process documentation and quality reviews.

Culture & Benefits

• Full-time, permanent employment.
• Work across multiple time zones in a hybrid or remote environment.
• Long periods of computer-based work using video technology.
• Travel may be required depending on company needs.
• Reasonable accommodations are available in accordance with the Americans with Disabilities Act.

Hiring process

• Employment is subject to a pre-employment criminal background check.