Job Summary: The Enrollment Specialist is responsible for providing assistance in all aspects of the Health Benefits Resource Center, which provides enrollment assistance to families and their children in a variety of health-related programs and other support services for Wesley Community & Health Centers (Wesley).
Essential Duties and Responsibilities: To perform this job successfully, an individual must be able to perform the following satisfactorily; other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Provides eligibility screening and enrollment assistance for uninsured and underinsured patients.
• Screens all uninsured clients for any government and/or private health insurance coverage, and if none, then works to obtain eligibility for entitlement programs, and works to qualify them into county, state, or hospital assistance program.
• Answers incoming calls and supports Wesley Health Center services and special events.
• Participates in outreach events and provides onsite enrollment assistance with specific agencies.
• Conducts activities in accordance with the Outreach Plan as assigned by the Outreach and Enrollment Program.
• Accomplishes daily enrollment/disenrollment operations, including application review, entering applications into system and submissions to health insurances, and obtaining missing information for enrollment completion.
• Interacts with Program Director and Medical Management to assure accuracy of outgoing demographic and special status eligibility information.
• Investigate, analyze, and resolve outstanding issues to achieve customer satisfaction and takes responsibility for following through and bringing issues to closure.
• Maintains complete accurate documentation of all customer interactions and maintain production levels and quality goals.
• Participates in training and continuing education per agency and contract regulations.
• Performs other duties as assigned.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience
• High School/GED; some college preferred
• Excellent customer service skills
• Bilingual in Spanish and English preferred
• 1-year related customer service experience
• Technical computer skills
• Ability to work with a diverse population.
Language Ability – Read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Write routine reports and correspondence. Speak effectively before groups of customers or employees.
Mathematical Ability – Calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference and volume. Apply concepts of basic algebra and geometry.
Reasoning Ability – Apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Deal with problems involving several concrete variables in standardized situations.
Computer Skills – MS Office and MS Office 365, eClinicalWorks, PointCare Enrollment Management System, AuntBertha Community Resource Referral Tool
Certificates and Licenses
• Community Health Worker (CHW) Preferred
• Fingerprint clearance card
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