Enrollment Specialist

3 weeks ago

Buffalo, United States Evergreen Health Services Full time

Evergreen Health

The Enrollment Specialist provides health insurance enrollment assistance and education for patients living with, or at risk of acquiring HIV/AIDS in the agency’s HIV Insurance Enrollment Program (HIEP) grant. The Enrollment Specialist’s dual goals are to empower individuals to seek, access, and receive medical care and prescription drugs at little to no cost, and to ensure patient services will be reimbursed, enabling providers use the revenues to develop program capacity to meet the needs of the uninsured HIV population. The Enrollment Specialist works with the Program Enrollment Coordinator toward developing the quality and effectiveness of the program activities to ensure that annual program objectives are met.

As part of the essential functions of this role, the Enrollment Specialist:

  • Ensures that people who meet eligibility criteria will be enrolled in the program and receive assistance in applying for ADAP/ADAP Plus, Medicaid, ADAP Plus Insurance Continuation program (APIC), NYS of Health Marketplace coverage, or other available coverage options.

  • Assists patients with transitioning from ADAP and ADAP Plus to comprehensive Marketplace insurance coverage, APIC, and other supplemental coverage.

  • Assists patients with insurance enrollment through the NY State of Health Marketplace, along with tracking and assisting with any recertification needs.

  • Conducts outreach to promote the program with community health and HIV testing providers, and with HIV positive and high-risk individuals.

  • Maintains an inventory log of program supplies and outreach materials.

  • Assists in developing and annually updating the Health Insurance Enrollment Program’s policy and procedures manual.

  • Assists the Manager in developing and implementing the program’s annual workplan, community outreach/education action plans, and continuing quality improvement plans.

  • Assists the Manager during the annual site visit review process.

  • Develops social media and multimedia materials in conjunction with the marketing staff to enhance outreach and program promotion for all interventions.

  • Educates patients, internal staff and outside organizations about insurance coverage for HIV care and medications and the Health Insurance Enrollment Program in general.

  • Identifies individual patient barriers to care and develops a plan to address those barriers.

  • Screens and assesses all patients to ensure that they meet program eligibility criteria.

  • Makes referrals and links patients to culturally sensitive and appropriate services.

  • Tracks all referrals to insurance linkages; collects and reports program data required by the funding source (NYSDOH) and agency.

  • Works closely with Financial Counseling Center staff in assisting with linkage to insurance, verifying insurance coverage, and follow-up to ensure that they have successfully completed the application process.

  • Documents all required patient and service information in Medent and AIRS, according to the funder’s requirements and established program procedures.

  • Assists with monthly and annual reporting as needed.

Qualified candidate will have a Bachelor’s degree with experience in health or non-profit setting. Candidate must demonstrate excellent verbal and written communication skills, as well as interpersonal and customer services skills. Candidate will have a positive and team-oriented attitude with excellent customer services skills. Ability to handle sensitive material, maintaining the highest level of confidentiality and displaying sound judgment, essential. Candidate must have excellent organizational and time management skills and have high level of accuracy and attention to detail. Sensitivity toward cultural diversity, people living with HIV/AIDS and lifestyle and addiction issues essential.

Job type: Full-time

Required education/experience: Bachelor’s degree with experience in health or non-profit setting

Preferred Experience/Certifications: NY State of Health Certified Application Counselor (CAC); Experience working with insurance programs and/or HIV services

What Evergreen Health Offers You:

  • Multiple comprehensive medical health insurance plans for you to choose from

  • Dental and Vision coverage at no cost to you

  • Paid Time Off package that equals 4 weeks of time in your first year

  • 403b with a generous company match

  • Paid parking or monthly metro pass

  • Professional development opportunities

  • Paid lunch breaks

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