Manager of Enrollment & Reconciliation -
HealthCare Support is seeking a
Manager of Enrollment & Reconciliation to support a Medicare Advantage Plan, delivering accessible, culturally attuned healthcare to the diverse populations it serves in Huntington Beach, CA
Schedule:
Compensation:
-
$90,000 - $110K annually (depending on experience)
Daily Responsibilities:
-
Oversee and optimize all Medicare Advantage enrollment and reconciliation processes to ensure accuracy, compliance, and operational efficiency.
-
Serves as the organization’s expert on CMS rules, MARx transactions, eligibility policies, retroactive adjustments, and payment reconciliation requirements.
-
Leads the team by setting priorities, guiding goals, and ensuring high?quality data capture and reporting.
-
Manages MARx transaction processing, resolves rejections, reconciles CMS response files, and ensures alignment between internal systems and downstream partners like PBMs, claims, and finance.
-
Identifies discrepancies, maintains governance around enrollment and payment accuracy, and ensures timely corrective actions.
Qualifications:
-
Bachelor’s degree or equivalent combination of education and experience.
-
2 years of enrollment and reconciliation supervisory experience.
-
4 years of Medicare Enrollment experience at the health plan level.
-
Experience Medicare Advantage Enrollment and Reconciliation rules and regulations, including CMS enrollment policy, MARx processing, payment reconciliation, and audit requirements.
-
Expert-level knowledge of Medicare Advantage audit, compliance, enrollment, reconciliation, and regulatory reporting requirements
-
Expert knowledge of Medicare Advantage enrollment transactions, reconciliation processes, and CMS enrollment policy.
-
Advanced understanding of MARx transaction codes, CMS response files, and enrollment reconciliation workflows.
-
Ability to interpret and apply CMS guidance, HPMS memos, and the Plan Communications User Guide (PCUG) to operational scenarios.
Interested in this opportunity?
Click
Apply Now for immediate consideration, or reach out to our Recruiter, Melanie Williams with any questions:
-
Call: (407) 346-0844
-
Email:
[email protected]
-
Schedule a Call:
https://calendly.com/mw4
Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
#LI-Hybrid
#LI-MW1
