Full Job Description
The Patient Enrollment and Access Specialist will coordinate financial assessments of patients, bridge enrollment to Impanelment, and assist with clinical access for PrimeCare clients.
Duties and Responsibilities
Provide enrollment assistance (including, but not limited to, completing coverage applications, gathering required documentation, and troubleshooting the enrollment process) for uninsured children and adults to access subsidized, low-cost, and free health insurance programs through the Health Insurance Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP).
Enroll patients in Snap benefits and Cash Assistance, through DHS.
Provide structured patient education on health coverage, engage in follow-up conversations, and offer renewal assistance for enrolled individuals.
Enroll patients in, and maintain, PrimeCareHealth’s Financial Assistance program.
Assist in re-determination process for MCO members.
Ensure continuity of insurance eligibility to identify patients with current breaks in coverage.
Impanel of patients to medical home provider, based on direction from Manager of Enrollment,
Maintain health plan enrollment roster information, patient utilization history, and provider-weighted panel size, and patient preference, medical home provider panels.
Impanel new patients to provider panels in Athena by assigning a PCP relationship and following the weighted-panel guidelines for assignment.
Distribute outreach materials to patients to build coverage option awareness.
Work with patients and billing staff to troubleshoot and resolve billing issues.
Other duties as assigned.
Required Skills or Abilities
Knowledge of the health and human services infrastructure, health insurance programs, and public coverage options.
Ability to effectively develop and nurture relationships with a diverse group of stakeholders and communicate with potential enrollees.
Ability to work independently and coordinate multiple tasks.
Strong computer skills with proficiency in Outlook, Word, PowerPoint, Excel, internet-based applications, and the Microsoft operating system.
1. Must be able to remain in a stationary position 50% of the time.
Must be able to move around the clinic site 50% of the time.
Constantly operates a computer, computer printer, copy machine, and telephone.
Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
Must be able to transport from one site to another.
Must be able to cover other shifts as necessary.
Required Knowledge, Experience, or Licensure/Registration
Bilingual highly desirable. Polish/English or Spanish/English preferred.
Bachelor's Degree in Public Health, Health Education, Social Work or related field strongly preferred.
Experience working with large and/or diverse client populations and low-income families and individuals.
Excellent interpersonal, verbal, and written communication skills.
Excellent time management, organizational, and intermediate to advanced computer skills; fast learning ability to use new technologies and systems.
Committed to achieving results under demanding time frames.
Strong ability to manage and meet multiple deadlines and goals, and maintain documentation, according to required state and federal laws and regulations.
May require some non-traditional hours, including limited evening and weekend hours.