Enrollment Representative
Location: Sacramento, CA (Onsite)
Schedule: Full-Time | Monday-Friday | 8:00 AM-5:00 PM
Position Overview
We are seeking a detail-oriented Health Plan Enrollment Representative to support enrollment and eligibility operations for a healthcare plan. This role is responsible for processing member and group enrollments, eligibility updates, terminations, demographic changes, and enrollment record maintenance while ensuring compliance with regulatory requirements and data integrity standards.
The ideal candidate will have experience in health plan enrollment, healthcare administration, insurance operations, or eligibility processing and possess strong analytical, organizational, and customer service skills.
Responsibilities
Process new member and group enrollments, terminations, and eligibility updates
Maintain accurate member demographic information and primary care provider (PCP) assignments
Verify coverage eligibility and resolve enrollment discrepancies
Review enrollment files for accuracy, completeness, and compliance
Process retroactive eligibility transactions and corrections as needed
Upload, validate, and maintain enrollment data within internal systems and databases
Research and reconcile eligibility issues by collaborating with internal departments and external partners
Generate member correspondence and process requests such as replacement ID cards
Communicate with brokers, customers, vendors, Member Services, and internal teams to gather missing information and resolve enrollment concerns
Analyze transactional data and enrollment activity to ensure data accuracy
Support open enrollment periods, annual enrollment activities, and special projects
Maintain confidentiality of protected health information (PHI) and comply with regulatory requirements and audit standards
Required Qualifications
High school diploma or equivalent combination of education and experience
Minimum one year of recent experience in health plan enrollment, insurance operations, healthcare administration, eligibility processing, or a related field
Member and group enrollment processing
Eligibility verification
Enrollment terminations
PCP changes
Demographic updates
Retroactive eligibility corrections
Proficiency with Microsoft Office Suite, including Excel, Word, and PowerPoint
Experience working with databases, enrollment systems, data validation, and file management
Strong attention to detail and ability to work accurately in a high-volume environment
Key Competencies
Data accuracy and quality control
Organization and time management
Critical thinking and analytical skills
Customer service orientation
Ability to manage multiple priorities and deadlines
Collaboration and cross-functional communication
Regulatory compliance and confidentiality awareness
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Pay Details: $25.00 per hour
Search managed by: Savannah Mckillip
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.