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Disenrollment Specialist Jobs (NOW HIRING)

UPMC Health Plan

Enrollment Specialist I

Pittsburgh, PA · Hybrid

$20.70/hr

The Enrollment Specialist will be responsible for the creation and maintenance of eligibility in ... Understanding of varied and detailed enrollment and disenrollment requirements and processing rules ...

My3Tech Inc

Enrollment Specialist

Nashville, TN · On-site

OPS ENROLL SPECIALIST/Administrative Services Assistant **This is a onsite position - only ... Disenrollment functions: Reviews and processes all requested and approved disenrollments, whether ...

STI

Enrollment Specialist /Admin

Nashville, TN · On-site

Disenrollment functions: Reviews and processes all requested and approved disenrollments, whether ... The LTSS Operations team is requesting a contractor to assist with Enrollment Specialist level work ...

Pacific Health Group

CA · On-site

$27 - $33/hr

The QA Specialist serves as the internal auditor, workflow analyst, and process-improvement lead ... Monitor outreach, referral, and disenrollment workflows to ensure adherence to required timelines ...

Pacific Health Group

CA · On-site

$27 - $33/hr

The QA Specialist serves as the internal auditor, workflow analyst, and process-improvement lead ... Monitor outreach, referral, and disenrollment workflows to ensure adherence to required timelines ...

Pacific Health Group

CA · On-site

$27 - $33/hr

The QA Specialist serves as the internal auditor, workflow analyst, and process-improvement lead ... Monitor outreach, referral, and disenrollment workflows to ensure adherence to required timelines ...

Pacific Health Group

CA · On-site

$27 - $33/hr

The QA Specialist serves as the internal auditor, workflow analyst, and process-improvement lead ... Monitor outreach, referral, and disenrollment workflows to ensure adherence to required timelines ...

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How much do disenrollment specialist jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for disenrollment specialist in the United States is $24.95, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $28.85 per hour, depending on experience, location, and employer.

What is a disenrollment specialist?

Disenrollment Specialists are professionals who manage the process of terminating memberships, enrollments, or subscriptions, typically in healthcare, insurance, or membership-based organizations. Their responsibilities include processing requests to leave a plan or service, ensuring compliance with regulations, and providing information to customers about their options. They work to ensure a smooth transition for individuals leaving an organization, often handling sensitive information and addressing any concerns or questions clients may have during the disenrollment process.

What are some common challenges faced by disenrollment specialists when processing member terminations?

Disenrollment Specialists often encounter challenges such as navigating complex regulations, ensuring accurate documentation, and communicating sensitive information to members. They must handle large volumes of data and coordinate with multiple departments to verify eligibility and process requests efficiently. Additionally, managing emotional conversations and addressing concerns from members about coverage termination requires strong interpersonal skills, attention to detail, and a deep understanding of compliance standards.

What are the key skills and qualifications needed to thrive as a disenrollment specialist?

To thrive as a Disenrollment Specialist, you need a solid understanding of healthcare plan policies, strong administrative skills, and attention to detail, often supported by experience in health insurance or customer service. Familiarity with enrollment/disenrollment software systems, CRM platforms, and regulatory compliance tools is typically required. Excellent communication, problem-solving skills, and the ability to handle sensitive information discreetly are important soft skills in this role. These competencies ensure accurate processing of disenrollments, regulatory compliance, and positive experiences for both clients and internal teams.
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Disenrollment Specialist jobs near you
Infographic showing various Disenrollment Specialist job openings in the United States as of August 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 79% Physical, 2% Hybrid, and 19% Remote job distribution, with an average salary of $51,897 per year, or $25 per hour.

Enrollment Specialist I

UPMC Health Plan

Pittsburgh, PA • Hybrid

$20.70/hr

Full-time

Posted 22 days ago

Job description

UPMC Health Plan has an exciting opportunity for an Enrollment Specialist I position in the Medicare SNP Enrollment department. This is a full-time hybrid position based in the Pittsburgh/Erie area. While you'll primarily work remotely, you'll come into the office occasionally depending on departmental needs.

This position has a set rate of $20.70/hr.


The Enrollment Specialist will be responsible for the creation and maintenance of eligibility in the transactional system, responding to both internal and external customer inquiries, and resolving issues to meet or exceed service requirements. To successfully perform the role, an Enrollment Specialist must have a comprehensive understanding of enrollment regulations and complete all duties with strict regard to policies and procedures. Completes all duties with strict regard to policies and procedures set forth by Enrollment Services Manager, Centers for Medicare and Medicaid Services (CMS), Pennsylvania Department of Welfare (DPW), and Pennsylvania Insurance Department (PID). Performs duties related to the processing and maintenance of all member requested transactions, include generation of required letters to ensure enrollment and/or disenrollment processes are completed compliantly. The role also involves direct interaction with internal and external customers to resolve inquiries and concerns including but not limited to outbound phone calls to members.


Responsibilities:

  • Understanding of varied and detailed enrollment and disenrollment requirements and processing rules based upon the product (HMO, PPO, EPO, SNP, PDP, Select, Supplemental, or National Complimentary) and Individual vs. Employer Group, including, but not limited to, understanding and application of service areas by product.
  • Maintain employee/insured confidentiality.
  • Ability to analyze information to make appropriate decisions regarding enrollment/disenrollment, complying with applicable regulations and governance.
  • Interact with Sales staff to ensure all required date elements for completed application are received and any issues are addressed timely, in accordance with compliance requirements.
  • Ability to make eligibility determinations based on CMS (Part A/Part B Eligibility), DPW (Medical Assistance Eligibility), and/or PID requirements, in accordance with the application election period guidelines. Ability to accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance.
  • Comprehension and application of eligibility regulations to process enrollment transactions and generation of corresponding letters to members. Must keep up to date with new regulations and guidance.
  • Process all types of enrollment and disenrollment transactions in accordance with company policies and procedures in a timely manner while meeting production and quality goals.
  • Initiation and generate of appropriate correspondence based on type of transaction processed, includes initiation of outreach requests and written correspondence (letters), as necessary.
  • Daily clerical responsibilities related to processing and electronic storage of member correspondence.
  • Identify areas of concern or trends that may compromise client satisfaction or compliance with government regulations.
  • Support team projects within Enrollment Services; other projects as assigned.
  • High school graduate or equivalent required, college degree preferred.
  • 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

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