Medicare Enrollment Processor

Position Summary:

The Medicare Enrollment Processor will support the Medicare Advantage and Medex Medigap enrollment processes.

The Enrollment Processor is responsible for ensuring compliance with the Centers for Medicare and Medicaid Services (CMS) requirements for the accurate processing and timeliness of Medicare Advantage enrollments. The Medicare Advantage Enrollment Processor will review, research, and gather missing information to complete member enrollments.

In addition, the Enrollment Processor is also responsible for completing Medex and Dental Blue 65 enrollments while following the internal Underwriting Guidelines pertaining to these plans.

This position is eligible for the following personas: Resident, Mobile, and eWorker.

Key Responsibilities:

• Process Medicare Enrollment applications and related requests in an accurate and timely manner while ensuring that all related systems are updated correctly.
• Outreach to applicants or members to obtain additional information related to their applications and account.
• Review member communications for accuracy of content prior to mailing.
• Validate that all enrollments are entered into the pre-enrollment tool and that they are processed correctly.
• Participate in providing coverage for inquiries received in the Medicare Advantage and Medex dedicated mailboxes.
• Support the implementation of automated and digital processes that will improve our member’s experience and positively impact the growth of our membership.
• Collaborate on cross-training opportunities within the Medicare Advantage Enrollment team to build a versatile skill set and ensure departmental adaptability.
• Serve as a key resource on the internal Help Desk line, answering calls from service teams and delivering clear, accurate guidance on enrollment-related questions.

Qualifications:

• Strong written and verbal communication skills.                        
• Ability to work closely / successfully in a team environment or individually.
• Ability to work additional hours during peak inventory periods (notably during Open Enrollment from October – March).
• Demonstrate flexibility and willingness to be cross trained to support other job functions to ensure business unit success.
• Excellent time management and organizational skills; strong attention to detail.
• Knowledge of Medicare Advantage / CMS Chapter regulations preferred.
• Ability to work in fast-paced, deadline-driven dynamic environment.
• High degree of initiative; decision-making skills.
• Knowledge of customer service environment, including BlueView, RTMS, and NASCO preferred.

 Education/Relevant Experience:

• Ability to learn new systems
• Bachelor’s degree or equivalent work experience preferred
• 2+ years Medicare experience

Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.

Location

Time Type

Weekly Hours

Grade of Position

Number of Openings Available

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting.  We may ultimately pay more or less than the posted range, and the range may be modified in the future.  An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note:  No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

WHY Blue Cross Blue Shield of MA?

We understand that the confidence gap and imposter syndrome can  prevent  amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL.

As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue.

At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.