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Enrollment Analyst – ACA Enrollment
Peak HealthEnrollment Analyst processing ACA/Marketplace transactions for Peak Health’s health plan. Reconciling CMS records, validating eligibility, and supporting compliant enrollment operations.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing enrollment processes, including ACA/Marketplace and Medicare transactions, while ensuring compliance with regulatory standards. Proficient in data analysis, training development, and maintaining accurate member records.
Highest-signal resume keywords
Medicare Enrollment ProcessingACA/Marketplace Enrollment ProcessingData AnalysisSystem/User Acceptance TestingCustomer Service Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data EntryEnrollment ProcessingReconciliation OperationsEligibility ValidationTransaction ManagementRecord ManagementTraining DevelopmentQuality AuditingProblem-SolvingAttention to Detail
Soft Skills
OrganizationMultitaskingPlanningAnalytical Abilities
Tools & Technologies
Microsoft Office Professional SuiteEPICCMS ToolsMARxEDVREED SubmissionsTapestry
Industry Keywords
Health Insurance MarketplaceMedicareASO/CommercialEnrollment RegulationsFederally Facilitated Marketplace
About the role
Key responsibilities & impact- Review, execute, and oversee member enrollment application information processing for Peak Health’s Plan Suite
- Manage weekly enrollment files and daily ACA/Marketplace enrollment transactions
- Process new enrollments, maintenance transactions, cancellations, terminations, reinstatements, plan changes, and SEP requests
- Reconcile membership, coverage, Marketplace, CMS, and issuer records; resolve discrepancies, errors, rejects, and exceptions
- Maintain member enrollment records, APTC/CSR information, databases, and work queues
- Validate applicant eligibility, household information, coverage effective dates, enrollment status, and supporting documentation
- Process and research SNP, ACA/FFM, Medicare, and ASO enrollment applications and transactions
- Complete EDV monthly processes, REED submissions, CMS reconciliations, LEP data files, and MPWR files
- Monitor production and quality standards and conduct audits for regulatory compliance
- Respond to member inquiries regarding enrollment procedures, benefits, and eligibility
- Develop and deliver enrollment training for new hires and maintain job aids and standard operating procedures
- Participate in system testing, UAT, validation activities, Open Enrollment planning, and process improvement initiatives
- Analyze enrollment data, prepare management reports, identify trends and discrepancies, and recommend improvements
- Collaborate with underwriting, billing, customer service, Marketplace representatives, vendors, and other stakeholders
- Escalate issues appropriately and troubleshoot enrollment system problems
Requirements
What you’ll need- High school diploma or equivalent
- Three years of experience working with medical or institutional data entry
- Three years of customer service experience
- Two years of Medicare eligibility and Medicare enrollment processing experience
- Preferred: three or more years of ACA/Marketplace enrollment processing experience
- Experience working with Federally Facilitated Marketplace (FFM) enrollment operations
- Familiarity with Health Insurance Marketplace eligibility and enrollment regulations
- Familiarity with Medicare elections, transaction codes, reconciliation operations, LEP management, CMS tools, MARx, EDVs, and REED submissions
- At least one year of system/user acceptance testing experience
- At least one year of experience developing and delivering trainings
- Previous experience in EMR systems
- Working knowledge of administrative and clerical procedures, word processing, and records management
- Ability to navigate multiple systems simultaneously and work with minimal supervision
- Familiarity with medical insurance, ASO/Commercial, Medicare, and coordination of benefits enrollment processes
- Familiarity with Tapestry’s automatic filing order table
- Exceptional attention to detail, organization, multitasking, planning, documentation, analytical, and problem-solving abilities
- Proficiency with Microsoft Office Professional Suite, including Outlook, Word, Excel, and Access, Internet Explorer, and EPIC
- Ability to sit for extended periods
Benefits
Comp & perks- 🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Peak Health Website LinkedIn All Job Openings 51 - 200 employees 🏥 Healthcare 💼 Consulting 🛡️ Insurance Healthcare
- Consulting
- Insurance Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems. Enrollment Analyst – ACA Enrollment Job not on LinkedIn 🔥 55 minutes ago 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Apply Now Find Hiring Managers Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
- Review, execute, and oversee member enrollment application information processing for Peak Health’s Plan Suite
- Manage weekly enrollment files and daily ACA/Marketplace enrollment transactions
- Process new enrollments, maintenance transactions, cancellations, terminations, reinstatements, plan changes, and SEP requests
- Reconcile membership, coverage, Marketplace, CMS, and issuer records; resolve discrepancies, errors, rejects, and exceptions
- Maintain member enrollment records, APTC/CSR information, databases, and work queues
- Validate applicant eligibility, household information, coverage effective dates, enrollment status, and supporting documentation
- Process and research SNP, ACA/FFM, Medicare, and ASO enrollment applications and transactions
- Complete EDV monthly processes, REED submissions, CMS reconciliations, LEP data files, and MPWR files
- Monitor production and quality standards and conduct audits for regulatory compliance
- Respond to member inquiries regarding enrollment procedures, benefits, and eligibility
- Develop and deliver enrollment training for new hires and maintain job aids and standard operating procedures
- Participate in system testing, UAT, validation activities, Open Enrollment planning, and process improvement initiatives
- Analyze enrollment data, prepare management reports, identify trends and discrepancies, and recommend improvements
- Collaborate with underwriting, billing, customer service, Marketplace representatives, vendors, and other stakeholders
- Escalate issues appropriately and troubleshoot enrollment system problems 🎯 Requirements
- High school diploma or equivalent
- Three years of experience working with medical or institutional data entry
- Three years of customer service experience
- Two years of Medicare eligibility and Medicare enrollment processing experience
- Preferred: three or more years of ACA/Marketplace enrollment processing experience
- Experience working with Federally Facilitated Marketplace (FFM) enrollment operations
- Familiarity with Health Insurance Marketplace eligibility and enrollment regulations
- Familiarity with Medicare elections, transaction codes, reconciliation operations, LEP management, CMS tools, MARx, EDVs, and REED submissions
- At least one year of system/user acceptance testing experience
- At least one year of experience developing and delivering trainings
- Previous experience in EMR systems
- Working knowledge of administrative and clerical procedures, word processing, and records management
- Ability to navigate multiple systems simultaneously and work with minimal supervision
- Familiarity with medical insurance, ASO/Commercial, Medicare, and coordination of benefits enrollment processes
- Familiarity with Tapestry’s automatic filing order table
- Exceptional attention to detail, organization, multitasking, planning, documentation, analytical, and problem-solving abilities
- Proficiency with Microsoft Office Professional Suite, including Outlook, Word, Excel, and Access, Internet Explorer, and EPIC
- Ability to sit for extended periods Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Enrollment Analyst – ACA Enrollment 🔥 58 minutes ago WVU Medicine 10,000+ employees 🏥 Healthcare ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Enrollment Analyst processing ACA Marketplace transactions, eligibility, reconciliations, and member records for WVU Medicine’s Peak Health plan. Supporting CMS compliance, Open Enrollment, UAT, training, and process improvement. 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Informatics Analyst 🔥 1 hour ago Dearborn Group 1001 - 5000 🏥 Healthcare 🛡️ Insurance ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Informatic Analyst supporting SQL/VBA reporting solutions for Dearborn Group, which provides employer-paid and voluntary insurance products. Designing, testing, and delivering data-driven reports. 🇺🇸 United States – Remote 💵 $41.7k - $92.8k / year ⏰ Full Time 🟢 Junior 🟡 Mid-level 🧐 Analyst 🚫👨🎓 No degree required Workday Analyst 🔥 1 hour ago Geode Health 51 - 200 💼 Consulting 🛡️ Insurance 🏥 Healthcare Website LinkedIn All Job Openings Workday Analyst administering HR and finance systems for Geode Health, a national outpatient mental healthcare provider. Supporting modules, reporting, integrations, data integrity, and process improvements. 🇺🇸 United States – Remote 💵 $105k - $115k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst Provider Payment Appeals Analyst I 🔥 2 hours ago Elevance Health 10,000+ employees 🏥 Healthcare ⚕️ Healthcare Insurance 🤝 B2B Website LinkedIn All Job Openings Provider payment appeals analyst resolving healthcare payment disputes for Elevance Health, a company simplifying healthcare. Reviewing claims, investigating decisions, and determining appropriate resolutions. 🇺🇸 United States – Remote 💵 $22 - $34 / hour ⏰ Full Time 🟡 Mid-level 🟠 Senior 🧐 Analyst 🦅 H1B Visa Sponsor Partner Engagement Senior Analyst 🔥 2 hours ago DaVita Kidney Care 10,000+ employees 🏥 Healthcare ⚕️ Healthcare Insurance Website LinkedIn All Job Openings Senior Analyst advancing provider engagement programs for DaVita, a comprehensive kidney care provider. Managing cross-functional initiatives, presentations, and data-driven improvements supporting value-based care. 🇺🇸 United States – Remote 💵 $66.3k - $95k / year 💰 Post-IPO Debt on 2021-02 ⏰ Full Time 🟠 Senior 🧐 Analyst View More Analyst Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates About us Is Remote Rocketship legit? Privacy policy Terms of service Job board SEO course Remote Job Search MasterClass AI Apply Copilot OpenClaw job finder Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs