Enrollment Specialist (28571 )

Job Description

Dahl Consulting is currently partnering with a leading health insurance company. We work one-on-one with great candidates to help connect them with local employment opportunities.

This position will provide administrative and data entry support during the open enrollment period. This individual will take on essential day-to-day responsibilities to ensure smooth operational continuity. The Enrollment Specialist will perform membership data entry, manage enrollment inquiries, and support compliance with HIPAA and CMS regulations, ensuring timely and accurate enrollment processing for members.

Worksite Location : Sioux Falls, SD | onsite

Duration : Assignment ends Feb 1, 2026

Pay : $20 p / h W2

What You’ll Do as the Enrollment Specialist

• Perform basic data entry for membership applications, terminations, and change requests.
• Accurately update and maintain claims system data according to defined enrollment system guidelines, policies, and procedures.
• Implement HIPAA and COBRA requirements to ensure legal compliance and proper data handling.
• Monitor receipt and processing of daily / weekly / monthly transaction files from CMS, FFM, third-party vendors, and employer groups (self-funded and fully insured).
• Support the Enrollment Question Inbox by reviewing and processing inquiries submitted by agents in South Dakota. Tasks will be assigned (not self-selected) and filed within the document management system.
• Oversee delegated vendors handling enrollment transactions, including additions, changes, terminations, and ID card processing.
• Download, log, and reconcile electronic enrollment files from FTP and web platforms to ensure data accuracy and completeness.
• Audit enrollment data, identify and correct errors, perform root cause analysis, and document improvements.
• Collect and transmit CMS-required data elements for enrollment and disenrollment of beneficiaries per CMS guidelines.
• Verify group and member setup accuracy in the claims system to ensure proper claims processing and billing.
• Research and resolve enrollment discrepancies, track recurring issues, and report findings to leadership.
• Collaborate with internal teams using Microsoft 365 tools (Outlook, Teams) for communication, file sharing, and task management.
• Complete error resolution for electronic eligibility discrepancies and maintain documentation to support compliance and audit readiness

What You’ll Bring to the Enrollment Specialist Role