Overview
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Enrollment Quality Auditor based in the United St
Full job description
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for an Enrollment Quality Auditor based in the United States. This role is responsible for ensuring the accuracy, timeliness, and quality of health plan enrollment and eligibility transactions. You will audit new enrollments, disenrollments, eligibility redeterminations, retroactive actions, and plan or PCP changes for Medicaid members. The position combines detailed transaction review with quality reporting, associate feedback, and collaboration across operational and client teams. You will help ensure processing aligns with CMS requirements, state Medicaid regulations, contractual SLAs, and internal quality standards. Your findings will directly support production quality, training improvements, and operational performance. This is a fully remote opportunity suited to a detail-oriented professional who can work independently while collaborating effectively across teams and time zones.
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Verification notes
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