Field Health Benefit Rep - Bilingual Spanish (Facilitated Enroller)
About The Position
The Field Health Benefit Representative (Facilitated Enroller) educates and assists individuals with enrolling in affordable health insurance through the NY State of Health Marketplace, including Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified Health Plans (QHP), and Health & Recovery Plan (HARP). The role engages people who are uninsured or seeking new coverage and supports current members with renewals and benefit education. It follows the Affordable Care Act, FE Integrity Guidelines, regulatory guidelines, and Fidelis Care standards, with a focus on customer experience and community engagement. This is a 100% community field-based position supporting Erie County, New York; the candidate must reside in Erie County. The schedule is Monday through Friday, with required work evenings and weekends as needed. The position requires a high school diploma or GED, basic computer skills, prior public-speaking experience, and a driver’s license for non-NYC counties. Two or more years of experience in managed care, sales, customer service, or a related area is preferred. Bilingual English/Spanish ability is highly preferred. The representative must complete and pass the New York State of Health-approved training program, become certified, and complete annual recertification requirements. The role also requires ongoing participation in trainings, updates, webinars, and other forums, and keeping current with Marketplace functionality and ACA and regulatory updates.
Requirements
- High school diploma or GED.
- Basic computer skills.
- Prior public-speaking experience.
- Valid driver’s license is mandatory for non-NYC counties.
- Must reside in Erie County, New York.
- Must complete and pass the NY State of Health-approved training program and become certified.
- Must complete required annual recertification courses and learnings.
- Must work evenings and weekends as required.
Nice To Haves
- Two or more years of experience in managed care, sales, customer service, or a related area.
- Bilingual English/Spanish ability.
- Sales experience.
- Strong communication skills.
- Healthcare experience.
- Strong computer skills.
Responsibilities
- Educate and assist individuals with Marketplace enrollment in Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified Health Plans (QHP), and Health & Recovery Plan (HARP).
- Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
- Teach members to use Fidelis digital tools, including the member portal and mobile app.
- Describe plan features, benefits, cost-sharing mechanisms, and Marketplace metal tiers and explain how benefits vary by income level.
- Help consumers submit required documents by scan, fax, or mail and assist with premium payment submissions when required.
- Support existing members with renewals and recertifications.
- Provide culturally and linguistically appropriate assistance and information.
- Conduct public education activities and presentations about Fidelis Care products and Marketplace options; participate in ACA forums, workshops, and community events as requested.
- Maintain a daily activity-tracking tool and monitor the personal dashboard to follow up promptly and accurately on applications, leads, and consumer inquiries.
- Record follow-up dispositions in the required CRM and enter applicant demographic, enrollment-site, and PCP-selection data at the initial enrollment encounter.
- Keep current with Marketplace functionality and manage individual accounts effectively.
- Comply with conflict-of-interest standards and regulations; safeguard confidential information and Protected Health Information (PHI), and maintain discretion regarding business-related files, reports, and conversations.
- Participate in required trainings, updates, webinars, and other forums; complete the required Marketplace Facilitated Enroller (MFE) annual recertification.
- Perform other assigned duties and comply with company policies and standards.
Benefits
- Competitive pay
- Health insurance
- 401(k)
- Stock purchase plans
- Tuition reimbursement
- Paid time off
- Paid holidays
- Flexible approach to work schedules, including remote, hybrid, field, or office schedules
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
