I found the below instructions that fixed the issues for me.
https://support.comodo.com/index.php?_m=knowledgebase&_a=viewarticle&kbarticleid=1188
Enable-ExchangeCertificate : The certificate with thumbprint XXXXXXXXX was found but is not valid for use with Exchange Server
(reason: PrivateKeyMissing).
At line:1 char:27
+ Enable-ExchangeCertificate -Thumbprint XXXXXXXXX -Services "IIS"
The above error can as a result of multiple reasons. CSR was created with IIS and attempted to be installed through the Exchange Management Shell (EMS), CSR was created in EMS on another Exchange Server, a damaged certificate, or Windows simply "forgets" where it placed the PrivateKey for the certificate. It doesn't happen all the time, but sometimes the error can be a nuisance.
Option #1: Repair Damaged Certificate (Windows Server 2003/2008)
- Open MMC and add the Certificate Snap-In for the Local Computer account.
- Double-Click on the recently imported certificate. Note: In Windows Server 2008 it will be the certificate missing the golden key beside it.
- Select the Details tab.
- Click on the Serial Number field and copy that string. Note: You may use CTRL+C, but not right-click and copy.
- Open up a command prompt session. (cmd.exe aka DOS Prompt)
- Type: certutil -repairstore my "SerialNumber" (SerialNumber is that which was copied down in step 4.)
- After running the above command, go back to the MMC and Right-Click Certificates and select Refresh (or hit F5 in the MMC)
- Double-Click on the problem certificate. At the bottom of this window (General tab) it should state: "You have a private key that corresponds to this certificate." Note: In Windows Server 2008 there will be a golden key to the left of the certificate, so there is no need to double-click the certificate.
- Now that the Private Key is attached to the certificate, please proceed to enable Exchange Services via Enable-ExchangeCertificate.
Option #2: Remove and Re-Install Certificate (Windows Server 2003/2008)
- Verify the certificate doesn't have it's private key.
In the MMC and double-click the recently imported certificate. (Be sure that you're using the Certificate Snap-In for the Local Computer account!)
Note: In Windows Server 2008 it will be the certificate missing the golden key beside it. - Right-Click on the certificate and click Delete.
- Re-install the Certificate