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Medicare Enrollment Manager Jobs (NOW HIRING)

RxAdvance

Medicare Enrollment & Billing Specialist

Tampa, FL · On-site

$17.50 - $23.75/hr

... benefit management solutions that run on the same platform, made possible by our creation, Aria ... Job Summary: The Medicare Billing & Enrollment Specialist is responsible for the enrollment ...

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Medicare Enrollment Manager information

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$35.5K

$86.4K

$117K

How much do medicare enrollment manager jobs pay per year?

As of Aug 8, 2026, the average yearly pay for medicare enrollment manager in the United States is $86,379.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,000.00 and $116,500.00 per year, depending on experience, location, and employer.

What is the difference between Medicare Enrollment Manager vs Medicare Customer Service Representative?

AspectMedicare Enrollment ManagerMedicare Customer Service Representative
CredentialsTypically requires knowledge of Medicare policies, certifications may include insurance licensesCustomer service skills, basic Medicare knowledge, possibly some certifications
Work EnvironmentOffice-based, administrative, and managerial settingsCall centers, customer support centers, or remote
Employer & IndustryHealth insurance companies, government agencies, healthcare providersInsurance companies, healthcare providers, government programs

The Medicare Enrollment Manager focuses on overseeing enrollment processes, managing compliance, and coordinating with clients, often requiring specialized knowledge and certifications. In contrast, the Medicare Customer Service Representative primarily handles inquiries, provides information, and assists beneficiaries directly. Both roles are essential in the Medicare industry but differ in responsibilities, required credentials, and work environment.

What does a Medicare Enrollment Manager do?

A Medicare Enrollment Manager oversees the process of enrolling individuals into Medicare health plans, ensuring compliance with federal regulations and organizational policies. They manage a team that processes applications, resolves enrollment issues, and communicates with members and government agencies. Their responsibilities also include monitoring enrollment trends, training staff, and implementing process improvements to enhance efficiency and accuracy. The role requires strong knowledge of Medicare guidelines and excellent organizational and leadership skills.

What are the key skills and qualifications needed to thrive as a Medicare Enrollment Manager?

To thrive as a Medicare Enrollment Manager, you need in-depth knowledge of Medicare regulations, enrollment processes, and healthcare administration, often backed by a bachelor’s degree in healthcare or a related field. Familiarity with enrollment management systems, CRM software, and compliance documentation is typically required. Strong leadership, attention to detail, and clear communication are critical soft skills for managing teams and ensuring accurate enrollment. These skills and qualities are essential to maintain regulatory compliance, optimize enrollment efficiency, and deliver excellent service to beneficiaries.

What are some common challenges faced by a Medicare Enrollment Manager, and how can they be addressed?

A Medicare Enrollment Manager often navigates complex regulatory requirements and frequent updates to Medicare policies, which can create challenges in maintaining compliance and ensuring accurate enrollment processing. Another common challenge is coordinating across multiple teams, such as customer service, IT, and compliance, to resolve enrollment issues efficiently. Staying organized, fostering open communication, and regularly participating in training on Medicare regulations can help address these challenges. Additionally, leveraging technology to track applications and monitor compliance can streamline workflows and reduce errors.
More about Medicare Enrollment Manager jobs
What cities are hiring for Medicare Enrollment Manager jobs? Cities with the most Medicare Enrollment Manager job openings:
What are the most commonly searched types of Medicare Enrollment jobs? The most popular types of Medicare Enrollment jobs are:
What states have the most Medicare Enrollment Manager jobs? States with the most job openings for Medicare Enrollment Manager jobs include:
What job categories do people searching Medicare Enrollment Manager jobs look for? The top searched job categories for Medicare Enrollment Manager jobs are:
Medicare Enrollment Manager jobs near you
Infographic showing various Medicare Enrollment Manager job openings in the United States as of August 2026, with employment types broken down into 78% Full Time, 10% Part Time, 4% Temporary, and 8% Contract. Highlights an 75% In-person, 6% Hybrid, and 19% Remote job distribution, with an average salary of $86,379 per year, or $41.5 per hour.

Medicare Enrollment Specialist

Core Value Insurance Group LLC

Feasterville Trevose, PA • On-site

Full-time

Posted 8 days ago

Job description

The Medicare Enrollment Specialist is responsible for accurately completing Medicare enrollments for eligible beneficiaries while ensuring full compliance with CMS regulations and carrier requirements. This role serves as the final quality checkpoint before an application is submitted, verifying all enrollment details, reviewing plan benefits, and ensuring each beneficiary fully understands their coverage and enrollment decision. The Enrollment Specialist works closely with Producing Agents to deliver an exceptional customer experience while maintaining the highest standards of accuracy and compliance.
Essential Duties and Responsibilities
  • Review all information provided by the Producing Agent to ensure the enrollment package is complete before beginning the enrollment.
  • Conduct the required introduction and recording statement.
  • Re-read the Scope of Appointment (SOA) in its entirety.
  • Verify the Medicare plan name with the beneficiary.
  • Review and verify all physicians, specialists, and prescription medications.
  • Confirm the beneficiary understands if any providers are out-of-network.
  • Conduct a complete Summary of Benefits (SOB) review.
  • Review each prescription drug, including:
    • Applicable formulary tier.
    • Prior authorization requirements.
    • Quantity limits.
    • Step therapy requirements.
    • Any medications not included on the formulary.
  • Read the required enrollment and transition statements in full.
  • Obtain an affirmative response from the beneficiary acknowledging understanding before proceeding.
  • Complete the Medicare enrollment application by asking every application question directly to the beneficiary without pre-filling responses.
  • Verify all application information for completeness and accuracy.
  • Read all required CMS and carrier disclosures.
  • For D-SNP and C-SNP enrollments, complete all required disclosures before initiating the IVR process.
  • Obtain the beneficiary's application signature in accordance with carrier requirements.
  • Provide the beneficiary with their enrollment confirmation number.
  • Provide the beneficiary with the Producing Agent's direct contact information.
  • Complete a Health Risk Assessment (HRA) whenever available and applicable.
  • If an HRA cannot be completed, document the reason and notify the Producing Agent promptly.
  • Ensure all enrollments comply with CMS regulations, carrier guidelines, and company policies.
  • Maintain accurate documentation and protect confidential member information in accordance with HIPAA requirements.
  • Collaborate with Producing Agents, management, and carrier partners to resolve enrollment issues in a timely manner.
  • Perform other duties as assigned.

Qualifications
  • Active resident health insurance license in good standing.
  • Must be eligible to obtain and maintain appointments with all required Medicare carriers.
  • Prior Medicare Advantage, Prescription Drug Plan (PDP), Medicare Supplement, or health insurance enrollment experience preferred.
  • Working knowledge of CMS Medicare regulations and compliance requirements preferred.
  • Strong attention to detail and commitment to accuracy.
  • Excellent verbal communication and customer service skills.
  • Ability to explain complex benefit information clearly and professionally.
  • Strong organizational and time management skills.
  • Ability to work in a fast-paced, performance-driven environment.
  • Knowledge, Skills, and Abilities
  • Thorough understanding of Medicare enrollment processes and compliance requirements.
  • Ability to identify discrepancies and ensure complete, accurate applications.
  • Strong listening skills and ability to build rapport with beneficiaries.
  • Ability to manage multiple enrollments while maintaining quality standards.
  • Proficiency with CRM systems, enrollment platforms, and Microsoft Office applications.
  • Ability to maintain confidentiality and handle sensitive information with discretion.

Physical Requirements
  • Prolonged periods of sitting while working on a computer and speaking on the telephone.
  • Ability to remain focused during extended periods of customer interaction.
  • Ability to occasionally lift up to 15 pounds.

Work Environment
This position operates in a professional office or remote work environment and requires frequent interaction with beneficiaries, Producing Agents, carrier representatives, and internal departments. During the Medicare Annual Enrollment Period (AEP), additional hours, including evenings and weekends, may be required to meet business needs.

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