Patient Financial Associate/Coordinator/Navigator, Outreach and Enrollment

Description

JOB SUMMARY
To facilitate consumer enrollment in a Qualified Health Plan (QHP) through the State Marketplace and or other health programs such as Medicaid/CHIP and Medicare LIS by providing fair, impartial, and accurate information that assists consumers with submitting the eligibility applications. The Outreach and Enrollment Coordinator will conduct consumer assistance activities as well as outreach and education activities to consumers and businesses about the availability of these programs and insurance affordability to encourage participation. The Outreach and Enrollment Coordinator will provide all services for the public good and serve as a resource to all consumers, including but not limited to, existing patients of the health center as well as to consumers, particularly from communities that are under-served by and under-represented in the current health insurance market.  

REPORTING RELATIONSHIPS
This position reports directly to the Director of Patient Financial Services Training & Quality Improvement. 

Requirements

ESSENTIAL JOB DUTIES 

• Provide application assistance and facilitate enrollment of eligible patients and community members in health insurance programs.
• Provide self-pay patients with options to pay for services
• Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the State Marketplace and other health coverage programs such as Medicaid, CHIP and Medicare LIS. 
• Counseling patients on our Sliding Fee Discount program and processing applications.
• Implement outreach strategies to promote the availability of health insurance and encourage participation of consumers particularly in communities that are under-served and under-represented in the current health insurance market.
• Completes and maintains a daily log of activities, i.e., Medicaid, Marketplace, Medicare Extra help applications, approved/disapproved.
• Conduct outreach and education activities to educate health center patients, consumers, businesses, community organizations and other stakeholders about insurance affordability through the Marketplace, Medicaid, Medicare and or CHIP to encourage participation. 
• Provide information and assistance in the consumer’s preferred language and or provide limited-English proficiency consumers with oral and written notices of their rights to receive language assistance services and how to obtain such services.
• Provide referrals for consumers with questions, complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies. 
• Ensure the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent from unauthorized disclosures.   
• Demonstrate and maintain the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).
• Participate in monthly conference calls and regularly scheduled meetings with the Navigator Project Management team at PACHC and provide updates to discuss issues, best practices, and modifications or challenges with the federal application and/or online application for Medicare, Medicaid and CHIP. 
• Participate in Pennie and other required training for Assister certification and to enhance outreach and enrollment expertise.
• Assist with the development and dissemination of marketing and promotional materials for outreach, application assistance and education activities that are tailored to the health center service delivery area and target population.
• Deliver the highest quality medical customer service to all parties involved.
• Perform other duties as assigned.

QUALIFICATIONS REQUIRED

• High school degree or equivalent
• Pa Assister license or willing to obtain within 60 days of employment
• Experience with electronic medical records preferred
• Working knowledge of various insurances and the terminology 
• Excellent verbal and written communication skills
• Proficient in Excel and Word skills