Enrollment Specialist II

  • 6255 Quebec Pkwy, Commerce City, CO 80022, USA
  • Full-time

Company Description

Since 1970, Salud has been committed to providing a Medical Home to patients, where medical, dental, behavioral health services and clinical pharmacists work together and coordinate efforts in a team based system of care. We strive to improve the quality of our patient's lives who would otherwise have limited access to health care. We serve all individuals regardless of their insurance status or ability to pay.

Job Description

As an Enrollment Specialists II, you will be responsible for increasing public understanding around the Affordable Care Act and assist clients in establishing eligibility for and gaining access to Federal, State, and local programs that provide or financially support the provision of medical, social, educational or other related services.

Enrollment Specialists II, at Salud, will determine patient eligibility for and facilitate enrollment in affordable health insurance coverage through the Health Insurance Marketplaces (through Connect for Health Colorado (C4HCO)), Medicaid or the Children’s Health Insurance Program (CHP+).  As an aEnrollment Specialists II, you will attain the certification necessary to utilize the online system CBMS to perform Medicaid applications. Enrollment Specialists II also provides patients with basic information on Salud Family Health Centers, including information on Salud Policies and Procedures as approved by the Board, access to care and enrollment in other Salud programs such as the Colorado Indigent Care Program (CICP) or Clinic Rate.  Enrollment Specialists II may also promote programs and services through community outreach.

The Enrollment Specialist II position is part of the Career ladder education program. This program requires the completion of the career ladder program through level one. This includes completing all of the courses, passing the exams, having satisfactory reviews and obtaining the outside certification as quickly as these levels are available and within the parameters established by Salud.  Those unable to complete the ladder within the parameters set by the organization will not be allowed to continue in their current role.

Supervision Received:

Works under the direct supervision of the Business Manager(s) of the home clinic.  Position may report to more than one Business Manager if duties are split between clinic locations

Supervision Exercised:

No

Specific Duties:

  • Become trained and certified in the online system CBMS to assist Medicaid applicants to enroll in benefits.
  • Process paper Medicaid applications from non-MA Salud sites as well as fellow Enrollment Specialists on site as necessary.
  • Perform other MA site duties as assigned by the Program Enrollment Manager.
  • Deliver general education about C4HCO insurance programs, Medicaid, CHP+, CICP, Clinic Rate and/or other Salud programs and services that patients may be eligible for
  • Assist individuals and families in navigating and/or enrolling in programs, insurances, and services through in-person visits and follow-up communication or case management
  • Ensure individuals know about their health plan options through the C4HCO Marketplace and help them filter and sort based on those options
  • Make referrals as necessary to the C4HCO customer service center, certified brokers and/or Salud programs and services or community resources
  • Help individuals with understanding web-based decision tools to help narrow the choices for qualified health plans
  • Utilize the Enrollment Checklist and Salud Programs Eligibility Listing to provide patients with basic information on Salud, including information on Salud Policies and Procedures as approved by the Board and information on accessing care in our clinics
  • Follow policies and procedures as outlined by the Colorado Department of Health Care Policy and Financing or the Colorado Department of Public Health and Environment to determine program eligibility and enrollment practices
  • Maintain expertise about C4HCO insurance programs, Medicaid, CHP+, CICP, Clinic Rate and/or other programs and services at Salud
  • Explain Qualified Health Plans, Essential Health Benefits, and rights when using insurance
  • Provide information about tax credits and cost-sharing subsidies
  • Support clients with renewing coverage during appropriate renewal periods
  • Refer customers with appeals, grievances, and complaints to the appropriate agency
  • Enter accurate data into CBMS or other computer systems
  • Develop partnerships with community organizations, schools and businesses as needed or requested by supervisor
  • Present to both small and large groups; attending community events; accurately tracking and logging outreach activities as needed or requested by supervisor
  • Provide overall excellent, unbiased and culturally appropriate customer service to the community
  • Accurately track and records activities for reporting as required
  • Maintain a secure and trusting environment by not sharing information learned on the job except when necessary as determined by the Health Insurance Portability and Accountability Act (HIPAA)
  • Coordinate with all other departments to ensure patient satisfaction
  • Work in tandem with Customer Service Associates, Enrollment Specialists, Health Coverage Guides and County Medicaid Technicians to promote a seamless enrollment process in all programs and services offered at Salud.
  • Works in conjunction with other Medical Providers, Dental Providers, Behavioral Health Providers, and all other staff to ensure that the patients obtain the highest standards of integrated healthcare.  
  • Acts as a patient advocate for our vulnerable populations by ensuring that patients are fully informed and comfortable with their visit to SALUD. 

Follows procedures for the electronic health

  • For duties related to the Marketplace; training and certification will be provided by C4HCO.  
  • Position will be required to travel between Salud clinic locations based on scheduling needs.
  • Position will be required to work as a Salud team member, participating in meetings, retreats and special events as necessary.
  • Performs other duties as assigned

 

Qualifications

Knowledge, Skills, and Abilities:

  • Ability to grasp and implement new programs and information
  • Skilled in internet use and research
  • Highly proficient computer skills to include MS Word, Excel, PowerPoint, and Outlook
  • Ability to manage files and records and work actively with individuals needing assistance during in-person visits, community events or follow-up communication
  • Excellent oral and written communication skills, including presenting and speaking in public settings
  • Customer service experience including working with people in one-on-one settings and group setting
  • Ability to explain and summarize detailed concepts like Medicaid Enrollment Process or Essential Health Benefits in a way that the general population can understand
  • Sensitivity to low income and ethnic minority community a must
  • Ability to multitask, prioritize work and meet deadlines
  • Basic knowledge of health insurance and health service delivery
  • Good interpersonal skills and the ability to work well with members of the public
  • Access to reliable transportation
  • Background check required
  • Must work well with the other patient care team members
  • Sensitivity to low income and ethnic minority community a must

Education:

  • High school diploma or GED required

Experience:

  • No experience is necessary to hire as an Enrollment Specialist.
  • Knowledge of program rules for Medicaid, CICP, and CHP + preferred.
  • Bilingual English/Spanish preferred, may be required for some clinic locations.

Licensure:

As a participant in the Career Ladder Program, all front-line staff at Salud Family Health Centers are required to obtain the industry standard credential for health care staff.

Bloodborne Pathogen Risk Level:

Low risk for bloodborne pathogens

Physical Requirements:

Requires sitting for long periods of time. Some bending, stretching, reaching, crouching, pulling, lifting, carrying and handling required. Working under stress. Manual dexterity required for use of calculator, computer keyboard, photocopier, scanner, telephone and other office equipment.  Requires normal range of hearing and eyesight to record data electronically and to communicate with patients.

Additional Information

Salud Family Health Centers is an Equal Opportunity Employer. We prohibit unlawful discrimination against applicants or employees on the basis of age 40 and over, race, color, religion, national origin, sex, disability, sexual orientation, gender identity, or any other applicable status protected by federal, state, or local laws.  All your information will be kept confidential according to EEO guidelines.