Enrollment Representative

Position Summary

Champion is seeking an experienced Enrollment Representative to support Medicare Advantage enrollment operations. This position is responsible for the accurate and timely processing of enrollment, eligibility, and membership transactions while ensuring compliance with CMS regulations and company policies.

The ideal candidate has experience in Medicare Advantage or managed care enrollment, enjoys working in a fast-paced environment, and is committed to accuracy, compliance, and exceptional customer service.

Responsibilities

As an Enrollment Representative, you will:

• Process Medicare Advantage enrollment, disenrollment, eligibility, and membership transactions accurately and within required turnaround times.
• Review enrollment applications and supporting documentation for completeness, accuracy, and CMS compliance.
• Verify Medicare eligibility and required enrollment documentation.
• Enter, maintain, and update member information in enrollment systems.
• Process enrollment corrections, retroactive enrollments, eligibility updates, reconciliations, and membership adjustments.
• Conduct outbound member outreach, including Outbound Enrollment Verification (OEV) calls, to verify enrollment requests, obtain missing information, resolve discrepancies, and support CMS compliance requirements.
• Research and resolve enrollment discrepancies, transaction errors, and eligibility issues.
• Maintain accurate electronic documentation to support regulatory compliance and audit readiness.
• Respond to enrollment-related inquiries from members, brokers, providers, and internal departments.
• Partner with Member Services, Broker Relations, Marketing, Compliance, and other departments to resolve enrollment issues efficiently.
• Protect confidential member information and comply with HIPAA, CMS, and Fraud, Waste & Abuse (FWA) requirements.
• Participate in quality audits, training, and process improvement activities.
• Support departmental operations during Annual Enrollment Period (AEP), Open Enrollment Period (OEP), and other peak enrollment periods.
• Other duties as assigned.

Qualifications

Required

• High School Diploma or GED.
• Minimum 3 year of experience in Medicare Advantage, managed care, health plan enrollment, eligibility, customer service, or a related healthcare administrative role.
• Strong attention to detail and commitment to accuracy.
• Excellent organizational, analytical, and problem-solving skills.
• Effective verbal and written communication skills.
• Ability to manage multiple priorities while meeting deadlines.
• Ability to work effectively as part of a team and collaborate respectfully with coworkers, supervisors, and other departments.
• Ability to receive, understand, and follow instructions, established procedures, coaching, and supervisory direction.
• Flexibility to work overtime and weekends, as requested, during AEP, OEP, and other high-volume or peak operational periods.
• Proficiency with Microsoft Office applications.

Preferred

• Experience working in a CMS-regulated healthcare environment.
• Knowledge of Medicare Advantage enrollment processes and CMS regulations.
• Experience with enrollment and eligibility systems.
• Bilingual (English/Spanish) is a plus.

Pay: From $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $23