Health Benefit Rep (Bilingual Spanish)

Centene Corporation • Fairport, KS

1d • $23 - $40

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 representative engages prospective members who are uninsured or seeking new coverage and supports existing members with renewals and benefit education. The role serves Monroe County, New York, and involves community field-based travel. Assistance must be culturally and linguistically appropriate and conducted in compliance with the Affordable Care Act (ACA), FE Integrity Guidelines, regulatory guidelines, Fidelis Care standards, and applicable privacy and security requirements.

The HBR explains program eligibility, tax credits, cost-sharing reductions, plan features, Marketplace metal tiers, and Fidelis digital tools; helps consumers submit documents and premiums; and conducts public education, presentations, and community outreach. The representative tracks activity and leads, monitors applications, records follow-up and enrollment information in the required CRM, and keeps current with Marketplace functionality and ACA and regulatory updates. The position requires participation in trainings and annual Marketplace Facilitated Enroller recertification, as well as evening and weekend work when required.

Requirements

• High school diploma or GED.
• Basic computer skills.
• Mandatory driver's license for non-NYC counties.
• Complete and pass the NY State of Health-approved training program and become certified.
• Complete all required annual recertification courses and learnings.

Nice To Haves

• Bilingual English/Spanish skills are highly preferred.
• Two or more years of prior experience in managed care, sales, customer service, or a related area is preferred.
• Experience in customer service, healthcare, enrollment counseling or health navigation, community outreach, front-facing or field sales, public speaking, prospecting, tabling, and events.
• Comfort with field-based travel supporting Monroe County, New York.
• Experience with MS Office Suite and Salesforce.

Responsibilities

• Educate and assist individuals with enrolling in 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).
• Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
• Teach members about Fidelis digital tools, including the member portal and mobile app.
• Describe plan features, benefits, cost-sharing mechanisms, and Marketplace metal tiers.
• Assist consumers with submitting required documents by scan, fax, or mail, and help with premium payment submissions when required.
• Support existing members with renewals and recertifications.
• Provide culturally and linguistically appropriate assistance and protect confidential information and PHI.
• Conduct public education activities and presentations, and participate in ACA forums, workshops, and community events as requested.
• Maintain a daily activity tracking tool and monitor personal-dashboard applications to ensure timely and accurate follow-through.
• Review the personal dashboard daily, follow up on potential consumer leads and inquiries, and record dispositions accurately and promptly in the required CRM.
• Enter applicant demographic, enrollment-site, and PCP selection data in the CRM during the initial enrollment encounter.
• Keep abreast of Marketplace functionality and ACA and regulatory updates.
• Participate in required trainings, updates, webinars, and forums, and meet annual Marketplace Facilitated Enroller recertification requirements.
• Comply with conflict-of-interest standards, regulations, policies, and standards; maintain discretion regarding business-related information.
• Perform other duties as assigned or required.
• Work evenings and weekends as required.

Benefits

• Competitive pay.
• Health insurance.
• 401(k) and stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible approach to work, with remote, hybrid, field, or office work schedules.
• Additional forms of incentives may be included in total compensation.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED