Job Description

Job Title: Adjudication Enrollment Specialist

Job Overview:

We are seeking a highly motivated and detail-oriented individual to join our team as a Member Enrollment Specialist. The successful candidate will have a strong background in member enrollment processes, possess excellent analytical and communication skills, and stay updated on CMS guidelines and changes.

Responsibilities:

Process member enrollment forms, including data entry, file upload, and review.

Handle BEQ, DTRR, and Marx files processing.

Manage LEP and LIS Processing.

Handle ID card requests efficiently.

Process enrollment cancellations, disenrollments, and reinstatements.

Manage PBP changes, address changes, and PCP changes.

Update demographic information accurately.

Generate correspondence related to enrollment processes.

Perform CMS EDV Audit and adhere to MSP/COB Processing.

Handle Medicare Premium Billing Letters.

Generate reports as required.

Stay informed about CMS guidelines and changes.

Qualifications:

Bachelors degree or equivalent.

1-3 years of relevant experience in Member Enrollment.

Strong analytical skills.

Excellent communication skills, both oral and written.

Key Skills:

Proficient in member enrollment processes.

Ability to make/take phone calls to complete job duties.

Timely resolution of member complaints and other team-routed issues.

Stay updated on CMS changes.

BEQ/ DTRR/ Marx / OEV / Medicare Managed Care Chapter 2 / MA Enrollment and / Disenrollment Guidance / PCUG / Voyager/ Reveeler

Venue details,

Location: 2nd Floor, Prakash Towers, 141, OMR, Kottivakkam, Chennai, Tamil Nadu 600041.

Best regards,

HR Team, +91 9176332863

Synthesis Health Soft services & solutions.

Expertia AI Technologies