Healthcare Navigator

Saint James Health IncNewark, NJ

About The Position

The Healthcare Navigator is responsible for providing eligibility and enrollment assistance for the Medicaid, CHIP, and Federal Marketplace health insurance programs to patients of the health center and community residents. The Health Insurance Navigator will conduct outreach activities; and will provide education to existing health center patients and non-health center patients about affordable insurance options and Marketplace. Mains expertise in eligibility, enrollment, and program specifications and conducts public education activities to raise awareness about the Marketplace. Assists individuals with enrollment applications and understanding of eligibility for individual plans. Stay abreast of regulatory guidelines and insurance plan eligibility, authorization, and system requirements. Resolves any remaining issues such as needing providing documentation to maintain eligibility or any enrollment issues with the health insurance companies and help them enroll. Collaborates with the Case Management team to create patient-centered communication to improve performance, reimbursement and streamline processes. Attends community outreach events, health fairs and informational forums as required by the organization. Assists in tracking enrollment metrics and patient payments. Monitor and efficiently reconcile electronic work queues. Provides support and assistance with financial reports, projects and audits as required. Act as a resource/point person for the registration and clinical support teams. Perform all duties as assigned.

Requirements

  • Exchange Enrollment Facilitator Certificate or complete training within 30 days
  • 3+ years of Healthcare Insurance Enrollment experience preferred
  • Strong attention to detail
  • Efficient with time management
  • Excellent analytical and problem-solving skills
  • Proficient Microsoft Office skills, especially with Excel
  • Complete all related training and certifications

Responsibilities

  • Conduct outreach activities
  • Provide education to existing health center patients and non-health center patients about affordable insurance options and Marketplace
  • Maintain expertise in eligibility, enrollment, and program specifications and conducts public education activities to raise awareness about the Marketplace
  • Assist individuals with enrollment applications and understanding of eligibility for individual plans
  • Stay abreast of regulatory guidelines and insurance plan eligibility, authorization, and system requirements
  • Resolve any remaining issues such as needing providing documentation to maintain eligibility or any enrollment issues with the health insurance companies and help them enroll
  • Collaborate with the Case Management team to create patient-centered communication to improve performance, reimbursement and streamline processes
  • Attend community outreach events, health fairs and informational forums as required by the organization
  • Assist in tracking enrollment metrics and patient payments
  • Monitor and efficiently reconcile electronic work queues
  • Provide support and assistance with financial reports, projects and audits as required
  • Act as a resource/point person for the registration and clinical support teams
  • Perform all duties as assigned

Benefits

  • 403B
  • Health insurance
  • Dental
  • Vision
  • Paid time off
  • Sick Time

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

No Education Listed

Number of Employees

1-10 employees

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