Job ID: 7659238896
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Work Arrangement: Remote
Facility: UPMC Health Plan
Department: Medicare Enrollment
Union Position: No
Salary Range:$ 19.47-30.4 USD
Are you someone who thrives in a fast‑paced environment, enjoys solving problems, and takes pride in getting the details right? As an Enrollment Specialist I, you’ll play a meaningful role in helping our members access the care and coverage they need — all while growing your career in a supportive, team‑oriented environment.
This is more than just processing data. You’ll navigate multiple systems, make confident decisions based on regulatory guidelines, and ensure every enrollment and disenrollment is completed accurately and compliantly. If you’re motivated by precision, enjoy structured work, and want to be part of a team that values growth from within, this is a great fit.
This position is remote, and you’ll be equipped with UPMC‑provided technology (laptop/PC, dual monitors, phone) to ensure you can work successfully from home.
What You’ll Do
- Accurately processing enrollment and disenrollment transactions across multiple products (HMO, PPO, EPO, SNP, PDP, etc.) while meeting production and quality goals.
- Reviewing and applying CMS, DPW, and PID regulations to determine eligibility and identify appropriate election periods.
- Generating required letters and written communications to ensure compliant completion of enrollment activities.
- Responding to internal and external inquiries with professionalism, clarity, and a customer‑first mindset.
- Making scripted outreach calls when additional information is needed to complete a member’s request.
- Maintaining strict confidentiality and adhering to all regulatory and departmental policies.
- Identifying trends or issues that could impact compliance or member satisfaction and escalating them as needed.
- Completing daily clerical duties related to correspondence and electronic records.
- Supporting team projects and contributing to process improvements.
A Day in This Role Looks Like
You’ll move between systems, intake work through a production queue, troubleshoot enrollment issues, and complete member transactions quickly and accurately. During our busiest season (Medicare Annual Enrollment: Oct 15 – Jan), you’ll enjoy a fast‑moving environment and may need to offer weekend flexibility.
What You Need to Know
- Pay: Set rate of $20.70/hour
- Hours: Monday- Friday Daylight hours with occasional flexibility to work weekends during peak enrollment periods.
- Work Environment: Hybrid Role: Remote day-to-day work with occasional on‑site needs for technology or operational reasons.
- Training: Comprehensive on‑the‑job training
- Growth: Full benefits + a clear path for development and advancement
What You Bring
You’ll thrive in this role if you enjoy detailed work, learning complex rules, and using your analytical skills to make sound decisions. Success here means being organized, proactive, and committed to quality.
Why You’ll Love This Role
- You’ll build expertise in Medicare, Medicaid, and commercial insurance enrollment.
- You’ll work in a supportive team where accuracy, learning, and problem‑solving are valued.
- Your work has a real impact on people’s ability to access care.
Qualifications:
- High school graduate or equivalent required.
- Minimum of six months of customer service and/or call center experience.
- Ability to interpret and apply complex eligibility regulations as mandated by CMS, DPW, and PID. Demonstrates good organizational, interpersonal, leadership and communication skills.
- Attention to detail is critical to the success of this position, with skills in customer orientation.
- Will need to manage multiple tasks and projects. MS Office/PC skills required.
- Licensure, Certifications, and Clearances:
- UPMC is an Equal Opportunity Employer/Disability/Veteran
