Bilingual Insurance Outreach Navigator

North Shore Community Health Inc•Gloucester, MA

just now•Hybrid

About The Position

North Shore Community Health (NSCH) is an industry leader in the exceptional delivery of community healthcare. We are seeking a dedicated and detail-oriented Bilingual Insurance Outreach Navigator to join our team at North Shore Community Health (NSCH). The primary purpose of this role is to assist patients with navigating the financial complexities related to paying for healthcare. The Bilingual Insurance Outreach Navigator would be responsible for ensuring that community members can effectively enroll, re-enroll, or manage their insurance coverage or otherwise cover the cost of their healthcare services. This includes providing support for plan changes, managing essential personal documents, and offering internal financial assistance through sliding fee scales and payment plans. In addition to individual patient support, the Bilingual Insurance Outreach Navigator will also engage in outreach efforts to boost MassHealth C3 enrollment, build relationships with community organizations, and organize educational events. The successful candidate will maintain high-quality customer service, track personal metrics, and collaborate closely with other NSCH Navigators, all while ensuring compliance with state and federal guidelines and maintaining certification as a Certified Application Counselor (CAC). North Shore Community Health (NSCH) is a highly accomplished community health organization that prides itself on its compassionate approach to serving the surrounding communities with comprehensive and culturally sensitive care. With a strong commitment to excellence, NSCH provides: Comprehensive primary care. Dental services. Behavioral health care. Care management. Pharmacy services. Substance abuse disorder treatment. Nurse care management. Insurance enrollment assistance. NSCH operates service sites at Gloucester, Peabody, and Salem Family Health Centers, ensuring convenient access to care. Additionally, NSCH extends its reach through school-based health centers within the Salem and Peabody School Districts. NSCH collaborates with Bentley Academy, Collins Middle School, Horace Mann School, Bates Elementary School, and the Peabody Learning Academy for behavioral health services. As a community-based safety net healthcare provider, NSCH actively encourages diversity and welcomes staff members who reflect the rich tapestry of our communities. We highly value the contributions of our team members and offer a wide range of perks and comprehensive benefits. These include health and wellness benefits, tuition reimbursement, loan forgiveness opportunities, and other appealing benefits. We believe in supporting our employees from day one, and all eligible staff members can take advantage of these benefits right from the start of their employment at NSCH. We aim to foster a supportive and rewarding environment that empowers our team members to provide exceptional care to our communities.

Requirements

High school diploma or equivalent
At least one year of experience in non-profit or healthcare work, preferably in assisting community members in program enrollment.
Willingness to receive CAC certification within 3 months of employment
Working knowledge of insurances – specifically MassHealth – strongly preferred.
Fluency in English AND either Spanish or Portuguese
Demonstrated strong communication skills with individuals and/or groups
Proficiency in Microsoft Office applications (Excel, Word, PowerPoint)
Valid MA driver’s license
Maintains strict adherence to the NSCH Confidentiality policy
Incorporates NSCHI values, principles and mission statement into daily activities
Complies with all NSCHI personnel policies and procedures
Strong analytical, problem solving, planning and prioritization skills
Self-motivated and self-directed to work within a team and/or work independently
Extremely detail-oriented in both verifying own work as well as the work of others
As a health center, NSCH ensures that all employees comply with the annual requirements for vaccinations and health screenings. All employees must be vaccinated against COVID-19 as a condition of their employment unless they have been granted a religious or medical exception. Proof of COVID-19 vaccination must be provided, and prospective employees must be vaccinated before their first day of employment, submitting their vaccination record and pre-hire paperwork. If you need to request an exemption from the vaccine requirement or have any inquiries regarding this policy, please contact the Human Resources Department at [email protected].

Nice To Haves

Third party billing or medical reception experience strongly preferred
Experience working in Epic is strongly preferred

Responsibilities

Provide navigational services for MassHealth and ConnectorCare plans, assisting NSCH patients with enrollment, re-enrollment, and insurance management to ensure effective care delivery.
Act as a delegate for clients when necessary to overcome barriers to MassHealth or ConnectorCare enrollment.
Assist patients with North Shore's internal financial assistance programs, including sliding fee scales and payment plans.
Manage work queues and in-baskets within NSCH’s EHR to identify referrals to Patient Access Navigator services.
Work in a flexible environment to balance pre-scheduled appointments, walk-ins, and ad-hoc needs, ensuring high-quality customer service for NSCH patients.
Establish and maintain relationships with community organizations, organizing educational and enrollment events.
Attend occasional evening and weekend community events, such as health fairs and festivals, to educate and enroll consumers in insurance programs on-site.
Manage personal documents required for insurance enrollment professionally and in compliance with policies, even in non-traditional settings.
Utilize information from NSCH's EHR and MassHealth to identify and resolve eligibility and coverage issues, maintaining continuity of care for patients.
Performs outreach aimed at boosting MassHealth C3 enrollment, including engaging uninsured and underinsured patients, scheduling newly enrolled patients assigned to North Shore, and navigating changes to non-C3 ACO MassHealth patients seeking routine care at an NSCH health center.
Ensure that patients participating in plans with which North Shore maintains a value-based agreement are able to fully benefit from Value-Based care, are properly enrolled and engaged in care.
Fax and upload documents to the MassHealth portal as provided by patients.
Track personal metrics related to outreach, enrollment, and engagement.
Collaborate with other NSCH Navigators to ensure comprehensive patient care.
Attend all required state and federal enrollment training sessions.
Maintain certification as a Certified Application Counselor (CAC).