Medicare Enrollment Specialist Resume Example

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(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
Professional Summary
Ambitious, proactive, professional offering hands-on experience in different areas. More than five years of customer service experience within the banking market that includes but are not limited to administration, sales and cash management. Skilled in the use of modern computer applications. Organized and detail oriented, fast learner and resourceful. Excellent in interpersonal relations with co-workers and management alike. Fully Bilingual.
  • Guest services
  • Inventory control procedures
  • Merchandising expertise
  • Loss prevention
  • Cash register operations
  • Product promotions
NATIONAL COLLEGE Bayamón, PR Expected in 2003 Associates Degree : Information Systems - GPA : Information Systems Graduated with Honors and a medal for one of the most achieved.
Work History
Concentra - Medicare Enrollment Specialist
West Palm Beach, FL, 01/2015 - 01/2016
  • Proceses enrollment applications received on a daily basis.
  • Completes eligibility screens and routes approximately for timely submission to local departments of social services.
  • Ensure quality assurance and integrity forms are complete and accurate prior to transmitting the application for data entry.
  • Verifies prospective member eligibility and enrollment history through systems to include e-paces and member health services (MHS).
  • Ensures applications are labeled correctly and routed out of data management system timely and accurately.
  • Reviews, completes and monitors reports including the data entry 834 enrollment records.
  • Works as a team to accomplish larger application goals and independently with little supervision when completing assigned tasks or other responsibilities.
  • Serves as liaison between Enrollment and various departments.
  • Additional duties and special projects as assigned.
- Medicare Enrollment Representative
, , 01/2014 - 01/2015
  • Review applications and determine member eligibility using Marx,E-paces and job aides for enrollment purposes.
  • Key enrollment data from actual application into Healthfirst enrollment systems per eligibility application from member.
  • Reconcile member data in enrollment systems as required.
  • Attention to detail when processing Medicare applications.
  • Ability to make decisions for Medicare application approvals based on company and medicare guidelines withminimal supervision.
  • Working knowledge of medicare enrollment guidelines and regulations.
  • Ability to meet strict production deadlines in a fast enviroment.
- Member Service Representative
, , 01/2012 - 01/2014
  • Set up and cancel medical appointment transportation request Provide members and providers account eligibility Change Primary Care Physician (PCP), send ID cards and directories to members Provide members with provider locations Update members account information Micro-site HIX campaign- join HF (special project) Child Health Plus (CHP) outbound Delinquent payment campaign (special project) Process CHP payments for members Request account and payment update for member through maces Assist members with billing and claim issues.
Spokane Teachers Credit Union (Stcu) - Phone Representative/Contractor
City, STATE, 01/2011 - 01/2012
  • Annual Enrollments for medical benefit plans.
  • Add/Remove Dependents or Beneficiaries.
  • Reset Passwords.
Enterprise Rent-A-Car - Phone Representative
City, STATE, 01/2010 - 01/2011
  • Advise of Billing & Account Information.
  • Troubleshooting phones.
  • Make payments and payment arrangements.
  • Equipment up-sales.
AON HEWITT - Auxiliary Assistant
City, STATE, 01/2003 - 01/2010
  • Prepare reports pertaining to Visa Debit Card transmission according to the established operational procedures.
  • Responsible for approval the Visa Debit Card duplicates and regulars.
  • Accountable for the client's Visa Debit and ACM cards openings and closings.
  • Responsible of preparing the reject report for the Visa Debit Card.
  • Balancing the Open, Closed, Hot Cards reports.
- Bank Clerk
, , 01/2000 - 01/2003
  • Offered service and assistance to the customers with their banking transactions and other needs.

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Resume Overview

School Attended
Job Titles Held:
  • Medicare Enrollment Specialist
  • Medicare Enrollment Representative
  • Member Service Representative
  • Phone Representative/Contractor
  • Phone Representative
  • Auxiliary Assistant
  • Bank Clerk
  • Associates Degree

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