Enrollment Specialist – Health Insurance (Virtual Assistant)

Position Title: Enrollment Specialist – Health Insurance
Employment Type: Full-Time / Part-Time (Remote)
Department: Health Insurance Operations
Reports To: Enrollment Supervisor / Client Account Manager

Role Overview

The Enrollment Specialist is responsible for assisting prospective and existing members with health insurance enrollment, plan changes, renewals, and eligibility verification. This role requires strong attention to detail, excellent communication skills, and compliance with healthcare regulations such as HIPAA.

Key Responsibilities

• Assist members with new enrollments, plan changes, renewals, and terminations
• Explain benefits, coverage options, premiums, copays, and eligibility
• Verify member information and eligibility using enrollment systems and portals
• Process enrollment applications accurately and within required timelines
• Handle inbound and outbound calls, emails, and chat inquiries
• Resolve enrollment issues and escalate complex cases when necessary
• Maintain accurate documentation and case notes in CRM systems
• Ensure compliance with HIPAA and health insurance regulations
• Meet daily/weekly productivity and quality benchmarks
  
  

Qualifications

• 1+ year experience in health insurance enrollment, customer service, or healthcare support
• Familiarity with Medicare, Medicaid, ACA, or private health plans (preferred)
• Strong verbal and written English communication skills
• High attention to detail and data accuracy
• Ability to navigate multiple systems efficiently
• Reliable internet connection and quiet work environment
  
  

Preferred Skills

• Experience with enrollment platforms (e.g., Salesforce, HealthEdge, proprietary systems)
• Knowledge of enrollment periods and qualifying life events
• Call center or virtual assistant experience in healthcare
  
  

Key Performance Indicators (KPIs)

• Enrollment accuracy rate
• Call handling time and quality scores
• Member satisfaction ratings
• Compliance and documentation accuracy
  
  

Compliance & Confidentiality:

• Must strictly comply with HIPAA, PHI handling standards, and Avocado VA policies
• Completion of mandatory compliance and security training is required
  
  

Why Join Avocado VA:

• Work with established US healthcare and insurance clients
• Long-term role stability with growth opportunities
• Ongoing training, support, and upskilling
• Professional virtual work environment