Marketplace Facilitated Enroller

Summary

The Customer Assistor is responsible for educating and assisting individuals and families with the enrollment and recertification process for Marketplace and government-sponsored health insurance programs, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP), Qualified Health Plans (QHP), and other Individual Market products. This role also supports community outreach and business development activities designed to increase awareness, retention, and membership growth through partnerships with local businesses, community organizations, and public events.

Responsibilities

• Establish and maintain trusted relationships with community influencers, local agencies, grassroots organizations, community-based groups, and event participants within an assigned territory.
• Educate community members and organizations on available health insurance products, programs, benefits, and related healthcare offerings.
• Conduct outreach activities, health fairs, community events, and educational sessions to increase awareness of health insurance options and Company services.
• Proactively engage local businesses to provide information regarding healthcare offerings, applicable regulations, and available coverage options.
• Participate in departmental strategy discussions and provide customer feedback and market intelligence gathered through outreach activities.
• Collect, review, and assess household income and family information used to determine eligibility for health insurance programs, including Adjusted Premium Tax Credits (APTC) and Cost Sharing (CS) reductions.
• Assist applicants with gathering and submitting required documentation related to age, residency, income, and other eligibility requirements.
• Explain health insurance program options, product features, benefits, costs, and enrollment requirements based on an individual's circumstances.
• Support customer retention through onboarding practices and serve as an advocate for applicants throughout the enrollment process.
• Apply Marketplace guidelines, policies, and procedures when assisting current and prospective members.
• Communicate application requirements, eligibility criteria, and enrollment updates clearly and accurately.
• Read, interpret, and apply rules and regulations contained in the Marketplace Facilitated Enroller (MFE) Training Manual.
• Calculate and compare financial information required for enrollment, including tax return information and financial statements for self-employed applicants.
• Assess enrollment situations, identify barriers, and work with applicants and the Marketplace to resolve issues.
• Present information regarding eligibility, enrollment processes, and available health insurance products to community audiences.
• Meet with applicants at approved locations when additional enrollment resources are required.
• Attend annual enrollment events and educational sessions to remain current on program updates and requirements.
• Provide cross-coverage and support for team members during absences, schedule changes, outreach events, and peak enrollment periods.
• Maintain confidentiality when handling sensitive personal and financial information.
• Promote workplace safety and maintain organized work areas.

Requirements

Education Requirements
High School Diploma required. Associate Degree preferred.

Experience Requirements

• One to two years of experience in customer service, sales, Marketplace Facilitated Enrollment (MFE), or a related field preferred.
• New York State Marketplace Facilitated Enroller (MFE) training and certification required within three months of hire.
• Ability to work independently with minimal supervision while maintaining accuracy and attention to detail.
• Ability to travel as required.

Required Skills

• Knowledge of Child Health Plus, Essential Plan, Medicaid/Medicaid Managed Care, and Individual Market (Qualified Health Plan) products.
• Ability to evaluate member needs and research issues through resolution.
• Strong customer service and relationship-building skills.
• Excellent verbal and written communication skills.
• Ability to present information effectively to community organizations and diverse audiences.
• Ability to interpret and apply program rules, regulations, and enrollment guidelines.
• Strong organizational and time management skills.
• Ability to handle confidential information professionally and with discretion.
• Proficiency with Microsoft Office applications, including Word, Excel, and Access.
• Familiarity with email, calendar management, customer relationship management tools, and related business applications.
• Demonstrated understanding of basic mathematics, including addition, subtraction, multiplication, division, rounding, and unit measurements.
• Ability to communicate effectively with culturally diverse populations.
• Sensitivity and professionalism when collecting personal and confidential information, including income, household composition, and eligibility-related details.
• Ability to facilitate meetings and collaborate effectively with team members.

Preferred Skills

• Bilingual communication skills.
• Experience conducting community outreach, educational presentations, or public engagement activities.
• Experience working with health insurance enrollment programs and eligibility determination processes.

Pay

$21.00 - $21.00 /hr. Non-exempt positions are eligible for overtime at a rate of 1.5 times the base hourly rate for all hours worked in excess of 40 in a work week, or as required by state or local law. Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education and experience.

Benefits

Full-time employees are eligible to select from different benefits packages. Packages may include medical, dental, and vision benefits, health savings accounts with qualified medical plan enrollment, 10 paid days off, 3 days paid bereavement leave, 401(k) plan participation with employer match, life and disability insurance, commuter benefits, dependent care flexible spending account, accident insurance, critical illness insurance, hospital indemnity insurance, accommodations and reimbursement for work travel, and discretionary performance or recognition bonus. Sick leave and mobile phone reimbursement provided based on state or local law.