Job Description

Job Description

Job Description

Job Description: Medicare/ACA Enrollment Specialist

Position Overview

The Medicare/ACA Enrollment Specialist plays a critical role in guiding members through the decision-making process of choosing between Medicare and Individual Marketplace Plans. Leveraging deep expertise in both Medicare and ACA options, the specialist evaluates members’ health histories, prescription needs, and financial considerations to provide clear plan comparisons and ensure informed decision-making.

This role requires a balance of technical knowledge, strong interpersonal skills, and organizational excellence to manage client communications effectively, collaborate with Account Managers, and deliver a seamless enrollment experience.

This is a salaried position with no cold calling or lead generation required, allowing specialists to focus exclusively on guiding members and supporting clients.

About EMS

Founded in 2004, Enrollment Management Services (EMS) is a healthcare consulting firm dedicated to helping employers support the unique insurance needs of their employees. By combining education, enrollment guidance, and financial support, EMS reduces barriers to coverage and empowers members to select plans that best meet their individual needs.

At EMS, we are passionate about making healthcare more accessible and affordable for families while ensuring peace of mind for our clients. We value collaboration, diversity of thought, and continuous learning. Our team culture emphasizes professional development, mutual respect, and a growth mindset that drives improvement and innovation.

Key Responsibilities

Enrollment & Member Support
- Conduct Medicare and ACA plan comparisons using member-specific data (spending history, prescriptions, physician lists, diagnoses).
- Provide guidance on MAPD, Supplement/PDP, and Individual Plan options as applicable.
- Facilitate member enrollment through electronic and paper applications.
- Coordinate with FMOs and carriers to resolve policy issuance issues.
- Maintain clear and proactive communication with Account Managers and members to address information gaps.

Documentation & Compliance
- Track and maintain Medicare/ACA documentation in EMS’s database.
- Organize and store member files, comparisons, and plan-related documents.
- Ensure accurate recordkeeping in accordance with compliance standards.

Client Account Management
- Develop strategies and action plans for assigned client accounts.
- Set and monitor quarterly account-level goals to drive measurable value.
- Participate in monthly leadership check-ins to review account progress.
- Prioritize workload based on risk assessments across client groups.

Continuous Improvement
- Identify opportunities to enhance enrollment processes and improve service delivery.

Qualifications

Education & Experience
- Associate’s degree preferred; equivalent experience considered.
- 5+ years of experience in Medicare and/or Individual Plan enrollments strongly preferred.

Technical Skills
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and email management.
- Familiarity with cloud-based data storage (e.g., OneDrive).
- Experience with FMOs and enrollment software tools.
- Ability and willingness to obtain an insurance license through successful completion of the required exam.

Professional Skills
- Exceptional written and verbal communication abilities.
- Strong organizational and time-management skills.
- High attention to detail and accuracy.
- Proven ability to manage objections, resolve concerns, and foster positive member experiences.
- Solid understanding of insurance concepts (deductibles, coinsurance, premiums, risk management).
- Self-motivated with the ability to work independently in a fast-paced environment.
- Flexibility to travel up to 20% for on-site client visits. Company Description

Started in 2004, Enrollment Management Services is a healthcare consulting firm that helps employers develop tools and programs to better support employee’s unique insurance needs and opportunities. By providing a combination of education, enrollment specialists, and financial support, employers can reduce many of the barriers associated with other insurance options and allow their members to take advantage of the opportunities that best serve their unique needs.

At EMS, we enjoy helping people every day. We love being able to help families make their healthcare more affordable, and we love giving our clients peace of mind about the long-term sustainability of their healthcare offering. We value our coworkers highly and believe that bringing together people with different perspectives and backgrounds helps us to be better as a team. We invest in our people by providing training in technical and non-technical skills. We have a growth mindset, so we actively seek feedback from each other and strive to improve our process as we grow.

Company Description

Started in 2004, Enrollment Management Services is a healthcare consulting firm that helps employers develop tools and programs to better support employee’s unique insurance needs and opportunities. By providing a combination of education, enrollment specialists, and financial support, employers can reduce many of the barriers associated with other insurance options and allow their members to take advantage of the opportunities that best serve their unique needs.\r\n\r\nAt EMS, we enjoy helping people every day. We love being able to help families make their healthcare more affordable, and we love giving our clients peace of mind about the long-term sustainability of their healthcare offering. We value our coworkers highly and believe that bringing together people with different perspectives and backgrounds helps us to be better as a team. We invest in our people by providing training in technical and non-technical skills. We have a growth mindset, so we actively seek feedback from each other and strive to improve our process as we grow.

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