Field Health Benefit Rep

Centene Corporation•Utica, NY

1d•$23 - $40•Onsite

About The Position

The Health Benefit Representative (HBR) educates and assists individuals 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. Work must comply with the Affordable Care Act (ACA), FE Integrity Guidelines, regulatory guidelines, and Fidelis Care standards, with a focus on customer experience and community engagement. This is a field-based position working within Oneida County, New York. The representative explains coverage options, eligibility and financial assistance; helps consumers with applications, documents, premiums, renewals, and digital tools; and conducts public education and community outreach. The position requires accurate activity and application tracking in a CRM, timely follow-up on leads, protection of confidential and protected health information, and ongoing training and Marketplace recertification. Evening and weekend work is required. Fluency in a second language is highly preferred. Candidates must be authorized to work in the U.S. without current or future employment-based visa sponsorship. The pay range is $23.23–$39.61 per hour, adjusted based on factors including skills, experience, education, and employment status. Centene describes a comprehensive benefits package that includes competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off and holidays, and flexible work arrangements, subject to eligibility.

Requirements

High school diploma or GED.
Basic computer skills.
Prior public speaking experience.
Must complete and pass the NY State of Health-approved training program and become certified.
Must complete all required annual recertification courses and learning.
Must be authorized to work in the U.S. without the need for current or future employment-based visa sponsorship.
Must have a driver’s license for non-NYC counties.

Nice To Haves

Two or more years of prior experience in managed care, sales, customer service, or related experience.
Fluency in a second language is highly preferred.
Driver’s license is preferred for NYC counties.

Responsibilities

Educate and assist individuals enrolling in coverage through the NY State of Health Marketplace, including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans, and Health & Recovery Plan.
Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
Teach members how to use Fidelis digital tools, including the member portal and mobile app.
Describe plan features, benefits, cost-sharing mechanisms, and Marketplace metal tiers, including how benefits vary by income level.
Assist consumers with submitting required documents by scan, fax, or mail.
Support existing members with renewals and recertifications.
Help consumers submit premium payments when required.
Provide culturally and linguistically appropriate assistance.
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 applications in a personal dashboard for timely and accurate follow-through.
Review the personal dashboard daily and follow up on potential leads from consumers seeking assistance.
Keep current with Marketplace functionality to effectively manage individual accounts.
Follow up on new enrollment leads and consumer inquiries, recording dispositions accurately and promptly in the required CRM.
Enter applicant demographic, enrollment site, and PCP selection data in the required CRM during the initial enrollment encounter.
Comply with conflict-of-interest standards and regulations.
Work evenings and weekends.
Safeguard confidential information and protected health information from unauthorized access and comply with privacy and security standards.
Participate in required trainings, updates, webinars, and other forums relevant to the role.
Meet annual Marketplace Facilitated Enroller recertification requirements and complete required recertification courses and learning.
Keep abreast of ACA, Marketplace, industry, and regulatory updates.
Maintain discretion regarding business-related files, reports, and conversations under applicable state and federal statutes and regulations.
Perform other duties and tasks as assigned and comply with all policies and standards.