Health Insurance Specialist - $24.04 per hour
About The Position
The Health Insurance Specialist is responsible for maintaining the highest professional and ethical standards in representing Access to Health Network (AHN) to HIV/AIDS clients and business partners. The ideal candidate is a motivated, hard-working, organized individual who performs well under pressure and can multi-task. This position is responsible for assisting clients with enrolling into the appropriate insurance product, processing Nevada Medication Assistance Program (NMAP) referrals from partner agencies, processing binder payment to insurance carriers, as well as cost share assistance payments for medical, dental, and/ or vision claims/ invoices. Basic Requirements This role requires bilingual fluency in English and Spanish, a valid Government Issued Driver's License or ID card, and the ability to pass a State of Nevada background check. Candidates must comply with HIPAA regulations. Within 90 days of hire, an Exchange Enrollment Facilitator License (EEF) must be obtained (at the agency's expense) as well as the Community Health Worker certification (CHW) within one year. A general understanding of health insurance systems, AHN services, and administrative duties is essential. Attendance at staff meetings and regular check-ins with direct reports is also expected. Key Responsibilities The position involves working knowledge of healthcare programs such as Medicaid, Medicare, Nevada Check-Up, and others. Compassionate, respectful service to clients is essential. Responsibilities include eligibility screening for Ryan White services, processing referrals and premium payments, and assisting with enrollment in the Premium Assistance Program. You'll be expected to maintain accurate client records in CareWare and Salesforce, ensure timely and professional reporting, and determine payer sources for NMAP referrals. Building strong relationships with providers, partners, and funders is key. The role also requires adaptability to changing schedules and duties, critical thinking, and the ability to communicate complex concepts clearly. Familiarity with Salesforce and CAREWare is necessary, and other duties may be assigned as needed.
Requirements
- Bilingual fluency in English and Spanish
- Valid Government Issued Driver's License or ID card
- Ability to pass a State of Nevada background check
- Compliance with HIPAA regulations
- Exchange Enrollment Facilitator License (EEF) within 90 days of hire
- Community Health Worker certification (CHW) within one year
- General understanding of health insurance systems, AHN services, and administrative duties
- Attendance at staff meetings and regular check-ins with direct reports
- Working knowledge of healthcare programs such as Medicaid, Medicare, Nevada Check-Up, and others
- Compassionate, respectful service to clients
- Familiarity with Salesforce and CAREWare
- Critical thinking
- High School Diploma
- One year minimum in health insurance, sales, and health insurance specialist experience preferred
- Three years minimum of computer experience including Microsoft operating systems, word processing, spreadsheets, database input, and report generation
- Demonstrated experience in planning and execution of organizational communication
- Required to pass a background check through the State of Nevada
Nice To Haves
- AA Degree Preferred
Responsibilities
- Assisting clients with enrolling into the appropriate insurance product
- Processing Nevada Medication Assistance Program (NMAP) referrals from partner agencies
- Processing binder payment to insurance carriers
- Processing cost share assistance payments for medical, dental, and/ or vision claims/ invoices
- Eligibility screening for Ryan White services
- Processing referrals and premium payments
- Assisting with enrollment in the Premium Assistance Program
- Maintaining accurate client records in CareWare and Salesforce
- Ensuring timely and professional reporting
- Determining payer sources for NMAP referrals
- Building strong relationships with providers, partners, and funders
- Adaptability to changing schedules and duties
- Communicating complex concepts clearly
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
