Enrollment Specialist I

Location: Sacramento, CA/Hybrid 
Pay: $20.00 – $22.00 per hour

"Our purpose is strong, our impact is lasting, join us on the journey"
Western Health Advantage 

Western Health Advantage is looking for a motivated and detail-oriented Enrollment Specialist I to join our growing team. In this role, you will play an important part in ensuring our members receive accurate, timely enrollment support while delivering excellent service to brokers, employer groups, and Individual Advantage members.

This is an excellent opportunity for someone with health plan enrollment experience who enjoys problem-solving, working with data, and providing responsive customer support in a collaborative environment.

Why Join Western Health Advantage

• Opportunity to grow your career within a respected health plan organization

• Collaborative and supportive team environment

• Meaningful work that supports members’ access to healthcare coverage

What You’ll Do

As an Enrollment Specialist I, you will help ensure member eligibility, enrollment records, and demographic data are accurate and up to date across our systems.

Key responsibilities include:

• Respond to incoming calls from brokers, employer groups, and Individual Advantage members regarding eligibility and enrollment inquiries.

• Communicate eligibility requirements and enrollment status updates to brokers, employer groups, and internal teams.

• Process enrollment-related transactions including:

  • Member additions and terminations

  • ID card requests

  • Primary Care Physician (PCP) changes

  • Address updates

• Review and process paper and electronic enrollment forms with strong attention to detail.

• Maintain a detailed working knowledge of enrollment requirements outlined in the Evidence of Coverage Handbook and Group Service Agreement.

• Achieve and maintain data entry accuracy and timeliness scores of 97% or higher.

• Collaborate with Individual Sales and Premium Billing teams to resolve escalated cases.

• Participate in team meetings, technical discussions, and operational updates.

• Support additional projects and department initiatives as needed.

What You Bring

Required Qualifications

• High School Diploma or equivalent.

• 2+ years of health plan enrollment experience (HMO experience preferred).

• Ability to work extended hours during the week and Saturdays during Open Enrollment periods.

Preferred Qualifications

• Experience with Facets Application Software.

• Previous experience supporting enrollment operations within a health plan.

Skills & Abilities

• Strong attention to detail and commitment to accuracy.

• Excellent communication skills with the ability to support members, brokers, and internal teams.

• Intermediate computer proficiency including:

  • Email and database systems

  • Word processing and spreadsheets

  • Creating formulas and graphs in Excel and importing them into Word documents

• Ability to read, write, speak, and understand the primary language(s) used in the workplace.

Join Western Health Advantage and help ensure our members receive accurate, reliable enrollment support that keeps their healthcare coverage running smoothly.
 

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.