Health Insurance Navigator

Western North Carolina Community Health Services•Asheville, NC

7d•Onsite

About The Position

Western North Carolina Community Health Services (WNCCHS) is seeking a full-time Insurance Navigator, a role requiring a passion for patient experience and interaction. This position involves becoming a certified application counselor responsible for outreach, education, and assistance to patients and the public regarding North Carolina Medicaid and Qualified Health Plans (QHP) through the Affordable Care Act (ACA) Health Insurance Marketplace. The navigator will help patients understand their enrollment options, assist with application preparation and submission, and resolve administrative issues with healthcare payers.

Requirements

At least one year in a customer-facing role in any service-related industry.
Knowledge of federal poverty level as applied to sliding fee scales.
Sliding fee scale experience required.
High School diploma or equivalent required.

Nice To Haves

At least one year in a medical office setting is preferred.
Bilingual English/Spanish, preferred.

Responsibilities

Demonstrates competency in performing the position responsibilities of the Patient Access Specialist I and II roles when needed, including patient registration, check-in/out, co-pay collections, eligibility determination, and all front desk workflows.
Successfully completes the North Carolina Certified Application Counselor exam; complies with all continuing education and recertification requirements.
Conducts and participates in outreach activities aimed at engaging patients and encouraging health insurance application.
Provides information to patients and the public about North Carolina Medicaid programs and the full range of options for which they are eligible.
Helps patients achieve and maintain enrollment in North Carolina Medicaid by completing application forms, helping patients gather necessary documents, and following the process through final outcome.
Helps patients resolve administrative problems with health care payers (e.g., requesting a lost Medicare card, completing a PCP change form, or working with payers to change beneficiary provider assignment).
Clarifies distinctions among health coverage options and helps consumers make informed decisions about health coverage.
Assists consumers in submitting Marketplace and Medicaid eligibility applications using the federal exchange website or the NC E-Pass portal.
Supports patients through enrollment, appeals, and annual redetermination processes.
Agrees to serve consumers’ best interests.
Complies with privacy and security standards.
Provides professional and confidential assistance to all patients seeking health benefits.
Participates in mandatory in-services, drills, staff meetings and other trainings.
Performs duties in a prioritized, organized, and orderly manner to maximize efficiency and productivity.
Facilitates the maintenance of a clean, neat and well-organized work area.
Participates in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and/or controlling program goals, objectives and/or services.
Supports current incentive, regulatory, and certification requirements (such as PCMH and UDS) through documentation, participation in initiatives, and other activities as directed.
Performs other duties as assigned.

Benefits

Competitive health plans for employees and dependents including Medical, Dental, Vision, and Telehealth
Up to Eleven (11) Paid Holidays
Up to Two (2) Floating Holidays
Accrued PTO (total of 156 hours 1st year)
403b Retirement Savings with Match
Employer Paid Life Insurance
HRSA and Public Non-Profit Student Loan Forgiveness
Monthly Staff Meetings and Training
Relias Learning Management System
Continued Medical Education (CME) & Continuing Education (CEU)