Membership Operations Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Execute daily operational tasks related to enrollment, billing, and reconciliation of Medicare and Medicaid member data and payments.

• Make autonomous decisions concerning standard operational activities by utilizing established procedures and professional expertise.

• Detect discrepancies in member data and payments, resolve issues when feasible, and escalate as necessary.

• Utilize analytical skills to ensure data integrity and payment accuracy throughout the membership lifecycle.

• Keep precise, audit-ready documentation that supports CMS and organizational compliance requirements.

• Recognize opportunities for workflow and process enhancements within operational guidelines.

• Investigate AI and large language model tools for data analysis, exception identification, and pattern recognition.

• Collaborate with colleagues and cross-functional partners, actively participating in team meetings and process improvement initiatives.

• Remain updated on operational knowledge, internal systems, and CMS and state regulatory requirements.

• Report directly to a Manager or Senior Manager of Membership Operations.

⛳️ Requirements

• 1–3 years of experience in healthcare operations, Medicare Advantage, enrollment, billing, or data reconciliation.

• Exceptional attention to detail and a proven record of accuracy in high-volume, data-intensive work.

• Proven capability to work independently, prioritize tasks, and meet deadlines with minimal oversight.

• Strong problem-solving and analytical abilities, including the skill to investigate discrepancies in data or payments.

• Effective written and verbal communication skills, with the capacity to collaborate across teams and functions.

• Interest in AI/LLM tools and a genuine desire to incorporate them into operational processes.

• Bachelor's degree in Business, Healthcare Administration, Data Analytics, or a related field (preferred).

• Familiarity with Medicare/Medicaid operations and CMS systems (preferred).

🏝️ Benefits

• Employer-sponsored health, dental, and vision plan with low or no premium.

• Generous paid time off.

• $100 monthly mobile or internet stipend.

• Stock options available for all employees.

• Bonus eligibility for all positions excluding Director and above.

• Commission eligibility for Sales roles.

• Parental leave program.

• 401K program.

• Equal opportunity, safe, and supportive work environment.

• Comprehensive total rewards package for full-time employees.