Field Health Benefit Representative (Facilitated Enroller)

Centene Corporation•Newburgh, NY

6d•Onsite

About The Position

The Field Health Benefit Representative (Facilitated Enroller) educates and assists individuals with enrolling in affordable health insurance coverage 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 representative engages prospective members who are uninsured or seeking new coverage and assists existing members with renewals and benefit education. The position is 100% field based within Orange County, New York, and requires evening and weekend work. Spanish fluency is highly preferred. All activities must comply with the Affordable Care Act, FE Integrity Guidelines, regulatory guidelines, Fidelis Care standards, conflict-of-interest rules, and applicable privacy and security requirements. The representative participates in required training and annual Marketplace Facilitated Enroller recertification, and keeps current with Marketplace functionality and ACA and regulatory updates. Applicants must be authorized to work in the U.S. without current or future employment-based visa sponsorship. A high school diploma or GED, basic computer skills, and prior public speaking experience are required. Two or more years of experience in managed care, sales, customer service, or a related area is preferred. A driver's license is preferred for NYC counties and mandatory for non-NYC counties. The representative must complete and pass the NY State of Health-approved training program and all required annual recertification courses. Centene offers competitive pay and a benefits package that includes health insurance, a 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays. Benefits may depend on program eligibility; total compensation may include incentives. Pay is adjusted based on individual qualifications and other job-related factors.

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 required annual recertification courses and learnings.
Must be authorized to work in the U.S. without current or future employment-based visa sponsorship.
Must work evenings and weekends.
Driver's license is mandatory for non-NYC counties; preferred for NYC counties.

Nice To Haves

Two or more years of prior experience in managed care, sales, customer service, or a related area.
Fluency in Spanish.
Driver's license 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 on 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 and how benefits vary by income level.
Assist consumers with submitting required documents by scan, fax, or mail.
Support existing members with renewals and recertifications, and help consumers submit premium payments when required.
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 applications in the personal dashboard to ensure timely, accurate follow-through.
Review the personal dashboard daily and follow up on potential consumer leads and inquiries.
Keep current with Marketplace functionality to manage individual accounts effectively.
Record follow-up 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.
Protect confidential information and PHI from unauthorized access, and maintain discretion regarding business-related files, reports, and conversations.
Participate in trainings, updates, webinars, and other forums needed to perform the role.
Meet annual Marketplace Facilitated Enroller recertification requirements and stay current on ACA and Marketplace regulatory updates.
Perform other duties as assigned and comply with applicable policies and standards.