Health Insurance and Services Navigator I

HealthPoint Careers • Kent, WA

2d • Hybrid

About The Position

The Health Insurance and Services Navigator I ensures HealthPoint patients and community members have access to health insurance and essential support services by assessing eligibility, completing applications, and providing clear, accurate education on insurance and public benefit programs. This role requires the ability to explain complex eligibility determinations, coverage options, and next steps in a way patients can understand and act upon. The Health Insurance and Services Navigator I plays a critical role in reducing uninsured rates, preventing coverage gaps, and supporting continuity of care through accurate enrollment, effective communication, and timely follow-up. This role may require occasional travel between sites to provide coverage as needed. Compensation is dependent on skills and experience.

Requirements

• Bachelor’s Degree with a human service-related focus or one (1) to two (2) years of experience in health benefits or healthcare financial eligibility screening is required or equivalent combination of education and experience.
• Ability to explain complex insurance, eligibility, and public benefit information clearly and accurately to individuals with varying levels of health literacy.
• Ability to translate technical, regulatory, and policy-driven information into plain-language explanations that support patient understanding and informed decision-making.
• Ability to communicate sensitive information in a respectful, culturally responsive, and solution-focused manner.
• Ability to present information effectively in one-on-one and small group settings with patients, community members, and internal staff.
• Ability to define problems, collect relevant information, interpret eligibility and program requirements, and apply appropriate solutions.
• Ability to adapt to policy changes and resolve enrollment or access issues effectively.
• Proficiency with computer systems and intermediate skills in Microsoft Word, Excel, and Outlook.
• Ability to learn, navigate, and accurately use multiple eligibility, enrollment, documentation, and reporting systems.
• Must be comfortable working in a fast-paced, technology-driven environment, managing multiple applications simultaneously, and adapting to system updates and changes.
• Washington Healthplanfinder (WHPF) Navigator Certification required within one (1) month of hire and must be maintained in active status.
• Active certification includes completion of required ongoing training, testing, background checks, and recertification activities in accordance with Exchange and program requirements.
• Proof of COVID-19 vaccination is required prior to starting at HealthPoint. HealthPoint does not accept the Johnson & Johnson COVID-19 vaccine as proof of vaccination. Individuals who received the Johnson & Johnson vaccine must provide documentation of an alternate COVID-19 vaccine or vaccine series.
• As a condition of employment, all new hires must provide proof of required immunizations and/or immunity for: COVID-19, MMR (Measles, Mumps, Rubella), Varicella, Annual Influenza, TB QuantiFERON Gold titer draw
• Employees working in a HealthPoint clinic must also provide proof of: Tdap vaccination (within the last 10 years), Hepatitis B vaccination (for clinical positions with potential exposure to blood or bloodborne pathogens)
• Documentation must be provided before your start date.
• If you are unable to provide documentation, HealthPoint can provide required vaccinations or immunity titers at no cost.

Responsibilities

• Assist clients with eligibility screening, applications, renewals, and recertifications for Medicaid (Apple Health), Qualified Health Plans, Medicare Savings Programs, Basic Food, Family Planning, and other state or federal assistance programs.
• Explain the basics of health insurance, public benefits, plan options, coverage limits, and patient responsibilities using clear, plain-language communication tailored to the patient’s level of understanding.
• Explain eligibility determinations, approvals, denials, partial approvals, and required next steps, ensuring patients understand outcomes, timelines, and responsibilities.
• Assist patients in selecting insurance plans that best align with their healthcare needs, financial situation, and coverage requirements.
• Provide guidance on eligibility for subsidies and other financial assistance programs when applicable.
• Translate complex insurance and eligibility information, including income thresholds, renewal requirements, managed care assignments, premiums, cost-sharing, and documentation needs, into actionable guidance for patients.
• Verify patient understanding by summarizing outcomes and confirming comprehension of next steps verbally and in writing when appropriate.
• Communicate sensitive or unfavorable information, such as denials or coverage changes, in a respectful, supportive, and solution-focused manner.
• Ensure accurate and timely completion of applications, renewals, plan changes, and insurance assignments, including contacting the Health Care Authority (HCA), Washington Healthplanfinder (Exchange), Public Health, Managed Care Organizations, insurance carriers, or other appropriate state agencies directly on behalf of the patient to resolve enrollment, eligibility, or coverage issues as needed.
• Maintain consistent, complete, and compliant documentation of patient interactions in approved systems, while upholding strict confidentiality and privacy standards in accordance with Exchange, HCA, DSHS, HIPAA, and other applicable health information and data protection requirements.
• Monitor application and renewal status and perform proactive follow-up to prevent delays, denials, or gaps in coverage.
• Identify, analyze, and troubleshoot complex enrollment issues, discrepancies, or coverage concerns, coordinating with external partners and agencies to support resolution when standard processes do not resolve the issue.
• Maintain and develop effective working relationships with external organizations such as the Washington Healthplanfinder (WHPF), Health Care Authority (HCA), Department of Social and Health Services (DSHS), Public Health, and community-based organizations.
• Review, build, and act on reports that may require outreach to specific patient populations, including uninsured, unengaged, and aging-out patients.
• Remain current and actively participate in Annual Enrollment and Open Enrollment periods, including sharing updates, changes, and performance information with sites and serving as a point of contact for questions.
• Represent HealthPoint at community outreach and education events, in person or virtual, as determined by leadership.
• Attend internal and external meetings required of the role, which may include presenting information or sharing program updates.
• Assist in the development and implementation of outreach activities and materials to enhance patient access, enrollment outcomes, and customer service.
• Implement strategies to collect data on service access and enrollment issues through mechanisms such as surveys, questionnaires, reports, and time logs, and identify opportunities to improve current systems.
• Contribute to a positive work environment centered around teamwork, collaboration, and accountability.
• Demonstrate respectful, professional, and appropriate behavior.
• Demonstrate a commitment to the mission, core values and goals of HealthPoint and its healthcare delivery including the ability to integrate values integrity, wisdom, creativity, cooperation, responsibility, respect into appropriate programs and services.
• Attend and participate in staff meetings, trainings, committees and work group assignments as requested or appropriate.
• Other duties as assigned by supervisor.

Benefits

• Comprehensive health coverage – Medical, dental, and vision insurance for employees and eligible dependents, plus HSA and FSA options.
• Financial wellbeing – Employer-paid life insurance, AD&D, disability coverage, and a 401(k)-retirement plan with employer match.
• Time to recharge – Generous Paid Time Off (PTO), Extended Illness Time Away, eight (8) paid holidays, three (3) floating holidays, Compassion Time Away, and Opportunity Time Off for extended personal time away to rest and recharge.
• Well-being resources – Employee Assistance Program (EAP), employee wellness program, and access to voluntary benefits including supplemental life, critical illness, accident, identity theft, and pet insurance.
• Career development – Professional development, ongoing learning, and opportunities for career growth within a mission-driven organization.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level