Insurance Enrollment Community Health Worker (IE CHW)

Heartland Community Health Center – Lawrence, KS•Lawrence, KS

11d•Onsite

About The Position

The Insurance Enrollment Community Health Worker (IE CHW) plays a crucial role in the healthcare system. The primary responsibility is to guide individuals through the insurance enrollment process. The Insurance Enrollment Specialist will handle applications, collect information, provide advice, and determine the patients’ eligibility for insurance coverage and other enabling programs. The IE CHW will be skilled at assessing and screening patients for specific KS Medicaid, Medicare and Marketplace plans and programs. They will be able to make recommendations, help patients navigate the enrollment process and maintain meticulous records. An outstanding candidate will demonstrate exceptional communication skills and detail-oriented work. This role demands strong interpersonal skills, attention to detail, organization, and the ability to navigate complex information while providing excellent customer service. This role will also offer healthcare system education to help families know how to utilize their benefits and access Heartlands integrated services as well as other service providers. The IE CHW will also provide additional social service resources to improve their daily lives and mitigate barriers to care. The Insurance Enrollment CHW provides unbiased enrollment assistance and community outreach.

Requirements

High school diploma or equivalent.
Knowledge of health insurance programs, regulations, and policies.
Strong interpersonal and communication skills.
Detail-oriented with excellent organizational and time management abilities.
Proficient in using relevant computer applications and databases.
Demonstrated commitment to promoting diversity, equity, and inclusion.
Ability to read, write, and speak English.
Operate a computer and other office equipment, such as tablets, scanners, printers, and phones.
Adhere to process protocol or procedures.

Nice To Haves

Bachelor’s degree in a related field.
Experience in healthcare administration, insurance enrollment, or a related field.
Community Health Worker Certifications will be obtained once hired.

Responsibilities

Assist individuals in understanding enrollment requirements, procedures, and options, including explaining eligibility criteria, application processes, and required documentation.
Evaluate other unmet needs and connect patients with resources such as food pantries, employer assistance programs, and utility assistance.
Collect, review, and process enrollment applications, ensuring all necessary information is complete and accurate. Help patients determine eligibility for health insurance programs and guide them through the application process.
Serve as a point of contact for inquiries, providing information via phone, email, or in-person meetings. Ensure clear communication about deadlines, requirements, and procedures.
Provide one-on-one and group education about health insurance and how to access care. Conduct outreach and education at community sites, health fairs, and events to increase awareness of coverage options.
Stay updated on relevant regulations, policies, and compliance standards to ensure adherence to legal requirements throughout the enrollment process.
Address issues that arise during enrollment, such as missing information, discrepancies, or technical problems, and resolve them efficiently and effectively.
Maintain accurate records, generate reports, and track enrollment data. Document pertinent information in the electronic medical record.
Collaborate with other departments, such as front office, finance and billing, and Community Health Workers, to streamline processes and provide comprehensive support. Participate in external meetings, trainings, and work groups to build relationships and promote Heartland services.
Participate in the development and implementation of strategies to enhance the enrollment experience, streamline processes, and increase enrollment rates.
Perform other duties as assigned.