Medicaid Enrollment Representative Admin Building Fulltime In Person (Monday - Friday 8:00 am - 4:30 pm) About Us Health Partners of Western Ohio is an independent, non-profit and community-directed organization. We serve low-income areas and places without access to care. We’re led by a volunteer Board of Directors. Most of our board members are also patients. Our Mission is to eliminate gaps in health outcomes for all members of our community by providing access to quality, affordable, preventive and primary health care. SUMMARY: Responsible for providing education and assistance to health center patients and service area residents with the enrollment into affordable health insurance options including Health Insurance Exchange, Medicaid, Children’s Health Insurance Program (CHIP), and Medicare. Screens and assists uninsured and underinsured patients in obtaining public benefits charity or other financial sponsorship from outside agencies and charitable programs when financial need is indicated. Completes CR audits monthly. ESSENTIAL FUNCTIONS AND BASIC DUTIES:- Conducts “in reach” activities with currently uninsured health center patients and “outreach” to non-health center persons within the health center’s service area
- Complies with and successfully completes all required Certified Application Counselor (CAC) training.
- Demonstrates and maintains expertise in eligibility and enrollment rules and procedures; the Health Insurance Exchange options in the Marketplace and insurance affordability programs, including Medicaid and Medicare.
- Assists patients and/or consumers in obtaining access to a single application process that will enable them to determine if they, or a family member, are eligible for enrollment under Medicaid or CHIP, or if they are eligible for financial assistance (waiver) for qualified health plan offered through the Marketplace.
- Provides information and assistance in a fair, accurate and impartial manner that is culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.
- Demonstrates an understanding of the needs of the undeserved and vulnerable populations and abides by privacy and security standards.
- Respects and maintains patient confidentiality according to health center policy and HIPAA regulations.
- Assists with training staff on sliding fee scale.
- Completes audits of CR’s monthly
- Provides referrals to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the Public Health Services Act to address consumer grievances, complaints, or questions about their health plan, coverage or determination.
- Develops and maintains a tracking and follow-up system for Medicaid and other social services applications to ensure that all aspects of the process, from application through post-enrollment, have been completed and that the patient is able to receive appropriate services.
- Attends and participates in staff meetings.
- Documents in designated computer system all interaction with patients to ensure proper follow up once patient has been released.
- Promotes and maintains positive behaviors and professional atmosphere.
- Maintains patient financial records in EHR.
- Performs other related duties as they are assigned.
QUALIFICATIONS EDUCATION/CERTIFICATION: High School Diploma or equivalent is required, with Associates in Health or Human Services or related field preferred. REQUIRED KNOWLEDGE: Successful completion of in-house training. SKILLS/ABILITIES: - Communicating effectively in both written and verbal form.
- Understanding of the Medicaid enrollment process and low-income services.
- Knowledge of state and federally funded public benefits programs preferred.
- Knowledge and demonstration of eligibility and enrollment rules; knowledge of qualified health plan options as well as Medicare, Medicaid, Commercial and CHIP.
- Must be able to work independently.
- Maintain a valid driver’s license; ability to travel between health center sites and throughout the health center’s service area.
- Starting pay $21.60 and goes up based on experience in Federally Qualified Health Center billing
- Paid Time Off (PTO) – Accrued per pay
- Insurance (Medical, Dental, Vision, Life and Disability)
- Paid Holidays – 7 paid holidays
- 403b Retirement with up to 8% match (starts at 3% and increases with time of service at HPWO)
- Annual Reviews and Increases
- Employee Assistance Program
- Referral Bonus – Earn more by expanding our team
- Training Opportunities
- Eligible to apply for the Emerging Leaders Program after 1 year of service
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