Insurance Enrollment Community Health Worker (IE CHW)

Duties And Responsibilities

• Customer Guidance: Assist individuals in understanding the enrollment requirements, procedures, and options available.
• Resource Navigation: Evaluate other unmet needs and work to connect patients with resources such as food pantries, employer assistance programs, and utility assistance.
• Application Processing: Collect, review, and process enrollment applications, ensuring all necessary information is complete and accurate. May involve data entry, verification, and coordination with other departments or agencies.
• Communication: Serve as a point of contact for inquiries, providing information via phone, email, or in-person meetings. Clear communication about deadlines, requirements, and procedures is essential.
• Education: Provide one-on-one and group education about health insurance along with how to access care. Outreach and education at community sites and events.
• Compliance and Regulations: Stay updated on relevant regulations, policies, and compliance standards to ensure adherence to legal requirements throughout the enrollment process.
• Problem Resolution: Address issues that arise during enrollment, such as missing information, discrepancies, or technical problems, and resolve them efficiently and effectively.
• Documentation and Reporting: Maintain accurate records, generate reports, and track enrollment data. Helps in assessing enrollment trends and identifying areas for improvement.
• Collaboration: Collaborate with other departments, such as front office, finance and billing, and Community Health Workers, to streamline processes and provide comprehensive support to enrollees.
• Quality Improvement: Participate in the development and implementation of strategies to enhance the enrollment experience, streamline processes, and increase enrollment rates.

Qualifications

• High school diploma or equivalent; bachelor’s degree in a related field preferred.
• Experience in healthcare administration, insurance enrollment, or a related field preferred.
• Knowledge of health insurance programs, regulations, and policies.
• Strong interpersonal and communication skills.
• Detail-oriented with excellent organizational and time management abilities.
• Proficient in using relevant computer applications and databases.
• Demonstrated commitment to promoting diversity, equity, and inclusion.
• Community Health Worker Certifications will be obtained once hired.