The Certified Enrollment Coordinator will provide application assistance to underinsured and uninsured patients of Qualified Health Plans and insurance affordability programs including Masshealth and insurance programs offered through the Health Insurance Exchange (HIX). He/She interviews, assesses and screens patients for eligibility for qualified health and dental plans and assist with enrollment and account management. The Certified Enrollment Coordinator is responsible for tracking and processing accurate, complete and timely applications with regards to Lynn Community Health Center processes and procedures and consistent with the Certified Application Counselor Designation Agreement. Maintains a professional environment in a multi-provider, multidiscipline organization. Maintains a patient centered environment to ensure patients’ continuity of care; advocate for patients. Positive attitude towards co-workers and other health center departments. Complete the 10 hour ACA enrollment training and be certified as a Certified Application Counselor within 45 days of employment and maintain certification.
- Respect and maintain patient confidentiality in all aspects of care including use of electronic information.
- Treat all patients in a welcoming and professional manner.
- Demonstrate professionalism by appropriate attire, attendance, attitude, and behavior within the clinical setting.
- Contribute to the team effort by supporting all team members and maintaining an open and positive attitude.
- Welcome new employees to the team by assisting with their orientation to the team and mentoring them, as requested.
DUTIES AND RESPONSIBILITIES:
- Provides information about full range of medical and dental insurance programs available through the Health Insurance Exchange (HIX).
- Answers questions about the Qualified Health Plans (QHP) and Qualified Dental Plans (QDP).
- Interviews patients and utilizes a mathematical formula to determine eligibility for subsidized health assistance programs.
- Effectively communicates enrollment eligibility in a manner that is easily understood by patients.
- Assists patients with completing applications and renewals and identifies the documentation required for the health exchange to determine insurance eligibility.
- Informs applicant of important deadlines, coverage dates, etc.
- Assists patients with selecting or changing insurance plans; answers questions about plan benefits including but not limited to out-of-pocket expense, co-pays and deductibles.
- Assists patients with confidential applications for protected services; assists patients with enrolling into the Coordination Care Program (CCP) formerly known as Women’s Health Network.
- Provides voter registration information and assistance as needed; completes declination form for all applicants.
- Accurately records the status of all health care applications in the EPM.
- Verifies and updates patient demographic and insurance information in EPM.
- Work with LCHC billing, clinical support, social services staff, as well as hospital billing staff to facilitate access to care for health center patients.
- Provide client support and advocacy by investigating and responding to any billing questions/issues that arise between members and providers. Assist clients with search for network specialists when needed.
- Answers telephone calls in a courteous manner and promptly responds to all inquiries from staff, patients and general public or refers the caller to the appropriate resource.
- Submits monthly statistic report of work activity to Supervisor in timely manner.
- Provides input during attendance at regular staff meetings.
- Keeps up to date on insurance programs, benefits and regulations.
- Attends scheduled training sessions deemed necessary by the Supervisor and actively strive to improve performance
- Under the direction of the Supervisor provides a department orientation and participates in training new staff as needed.
- Provides coverage at the front desk as needed.
- Outreach Activities: As directed by supervisor, conducts outreach and education in the community regarding insurance and benefit eligibility and enrollment procedures. Outreach sites/venues include health fairs, community meetings, community events, and other agencies. Provides accurate reports to supervisor regarding events attended, activities conducted, number of participants, and time spent.
- High school diploma or equivalent
- Graduate of medical support office program preferred
- Demonstrated proficiency in computer applications (Microsoft Office)
- Have strong organizational skills with ability to appropriately prioritize
- Excellent communication skills (written and oral) professional demeanor, excellent problem solving skills and detail-oriented
- Ability to handle heavy caseload of patients
- History of good attendance and positive work attitude
- Experience working with insurance enrollment systems
- Familiarity with minority health access and social issues required
- Experience with and knowledge of the health needs of community health center populations
- Bilingual in Spanish, Russian, Arabic or Khmer preferred
Minimum of two years of Customer Service experience or equivalent combination of education and experience
- Up to date immunization and annual TB testing is required. Hepatitis B vaccine and annual flu immunization are strongly recommended. All necessary vaccines are available at no charge at the health center.
- Results of inquiry to Criminal Offender Record Investigation (CORI) must be acceptable under health center standards.
Lynn Community Health Center (LCHC) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, LCHC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. LCHC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of LCHC’s employees to perform their job duties may result in discipline up to and including discharge.
Job Posting # 18-097