Health Benefit Rep

Centene Corporation•New York, NY

1d•$23 - $40•Onsite

About The Position

The Health Benefit Representative (HBR) 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 uninsured individuals and people 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 an emphasis on customer experience and community engagement. This is a 100% field-based position working within the Bronx. The HBR conducts outreach and education, helps consumers navigate eligibility and enrollment, and completes accurate follow-up and documentation in required systems. The position requires evening and weekend work, participation in trainings and annual recertification, and careful protection of confidential information and protected health information. Applicants must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future.

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 employment-based visa sponsorship now or in the future.
Must work evenings and weekends.

Nice To Haves

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

Responsibilities

Educate and assist individuals enrolling in coverage through the NY State of Health Marketplace, including NYM, CHP, EP, QHP, and HARP.
Explain eligibility for public programs, federal premium tax credits, cost-sharing reductions, and 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, 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.
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 ensure timely, accurate applicant follow-through.
Review the personal dashboard daily, address and follow up on potential consumer leads, and follow up on new enrollment leads and inquiries.
Keep current on Marketplace functionalities 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.
Comply with conflict-of-interest standards and regulations.
Protect confidential information and PHI from unauthorized access, and maintain discretion regarding business-related files, reports, and conversations in accordance with applicable laws and regulations.
Participate in trainings, updates, webinars, and other forums needed to perform the role.
Meet annual Marketplace Facilitated Enroller (MFE) recertification requirements and keep abreast of ACA, Marketplace, industry, and regulatory updates.
Perform other duties as assigned and comply with all policies and standards.