Insurance Specialist LTE
3 weeks ago
Position Purpose
With the guidance of the Client Access Coordinator, the Health Insurance Specialist is responsible for completing ASA Health Insurance program screening, intakes, and eligibility reviews with HIV+ individuals seeking marketplace health plan, premium, copay/coinsurance, and deductible assistance. The Health Insurance Specialist makes referrals for health care and supportive services. In addition, the Health Insurance Specialist co-maintains a caseload of clients accessing health insurance assistance only, processing premium payments, assisting with medication co-payments and deductibles, and completing eligibility updates.
Essential Functions
- Conduct client intakes specific to health insurance premium and/or medication co-payment assistance.
- Obtain information relevant to the needs of clients by using client-centered and systems theory approaches.
- Assist in determining client eligibility for various ASA services and other community resources and obtain proper supporting documentation.
- Provide timely and accurate referrals to community AIDS services organizations, hospitals, and other medical providers as appropriate.
- Complete Affordable Care Act (ACA) training to assist with enrollment process, educate clients on health plan and provide on-going support after plan is purchased.
- Provide education on premium tax credits and cost-sharing subsidies, tax filing and reconciliation of tax credits.
- Maintain caseload of health insurance only clients, providing assistance with insurance premium payments and ongoing medication co-payments/deductibles.
- Maintain documentation and program notes in client records according to departmental standards by utilizing Provide Enterprise® client database.
- Conduct chart updates per policy on health insurance clients and obtain required documentation and verification.
- Complete client file updates to ensure thorough and accurate documentation of eligibility information and required health insurance assistance documents.
- Assist in preparing reports for grants and monitoring outcome reports.
- Meet deadlines for time sheets, client documentation, and required grant documents.
- Some College, High School Diploma required. Degree in related social services discipline preferred.
- Experience working with individuals of diverse cultures, ethnicities, socioeconomic backgrounds, sexual orientations, and gender identifications required.
- Medical third-party billing experience preferred.
- Knowledge of health insurance practices and/or third-party billing.
- Valid state Driver License, insurable driving record and access to a reliable insured vehicle.
- Skill in operating office equipment, such as personal computer, calculator, copier, facsimile machine, and telephone system.
- Ability to perform routine walking, standing, bending, lifting, and stooping during the course of day.
- Knowledge of HIV/AIDS, mental health, and substance abuse.
- Knowledge of diverse populations, HIV resourced and community resources.
- Ability to work comfortably with diverse populations, with sensitivity to issues concerning HIV and all disabilities.
- Ability to demonstrate good judgment, maintain strict confidentiality standards, and adhere to professional standards as defined by state and federal regulations.
- Ability to make sound decisions in accordance with organization's policies, procedures, and guidelines.
- Ability to prioritize multiple tasks and competing priorities.
- Ability to establish and maintain good working relationships with coworkers.
- Strong oral and written communication skills.
- Working knowledge of Spanish language (bilingual) is a plus.
Salary
$21.00/hour (Depending on Experience)
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