The Medicare Enrollment Representative is responsible for timely processing of enrollments using CMS guidelines and policies.
They are also responsible for timely completion of all correspondence and reporting functions associated with the Medicare Unit and have knowledge of how the Unit functions affect other Plan Units and Departments.
The Medicare Enrollment Representative will serve as backup to Customer Service by answering phone calls in a prompt and courteous manner (to achieve abandonment standards) and answering Member and Provider questions with a quick and accurate response.
- High School Diploma;
- Typing & Computer Skills;
- Self Starter, detail oriented, ability to prioritize and meet deadlines;
- Maintain confidentiality;
- Good communication skills;
- Computer, copier skills;
- Mathematical skills;
- Good work ethic (i.e. Adequate learning skills, even temperamnet, follows instrucions, retains information, works well with others);
- Easily adapts to changes in work requirement.
- Familiar with Medicare Enrollment/Disenrollment process;
- CPT and ICD-9 and ICD-10 coding;
- Medical and hospital claims;
- Prescription coding (NDC);
- Medical terminology;
- Familiar with CMS Regulations and Guidelines.