Specialist Healthcare Enrollment

About the role

Assist patients in enrolling in health insurance coverage and ensure accurate and timely eligibility maintenance. Support patients applying for health coverage through Healthcare.gov or state-based exchanges or through NJ Medicaid. Guide patients through plan selection, documentation, and rule navigation.

Responsibilities

• Support patients in enrolling in health insurance through Healthcare.gov or state-based exchanges
• Guide patients through choosing appropriate plans and completing required documentation
• Navigate plan rules and deadlines for patients
• Work closely with state health agencies, healthcare providers, and patients to ensure eligibility accuracy

Requirements

• Certified Application Counselor (CAC) for ACA Marketplace Enrollment
• 3 to 5 years of experience in healthcare enrollment
• High school diploma or equivalent required
• Associate’s degree in healthcare administration, public health, or related field preferred
• Bilingual fluency, particularly in Spanish, is highly preferred
• Working knowledge of health insurance terminology and plan structures
• Proficiency in enrollment platforms and data entry systems
• Familiarity with HIPAA and ACA compliance requirements
• Ability to interpret and apply eligibility criteria and federal/state healthcare regulations
• Basic understanding of EDI (electronic data interchange) in healthcare
• Empathetic, patient-first communication style
• Strong attention to detail and accuracy in data handling
• Analytical thinking and problem-solving for eligibility questions
• Adaptability to regulatory and process changes
• Excellent communication, organizational, technical, and interpersonal skills
• Possesses and demonstrates excellent communication, organizational, technical, and interpersonal skills
• Knowledge of Medicaid and Charity Care eligibility guidelines
• Previous work in a hospital, managed care organization, or insurance company
• Experience enrolling individuals in government or public health programs

Qualifications

• Certified Application Counselor (CAC) for ACA Marketplace Enrollment
• 3 to 5 years of experience in healthcare enrollment
• High school diploma or equivalent required
• Associate’s degree in healthcare administration, public health, or related field preferred
• Bilingual fluency, particularly in Spanish, is highly preferred
• Working knowledge of health insurance terminology and plan structures
• Proficiency in enrollment platforms and data entry systems
• Familiarity with HIPAA and ACA compliance requirements
• Ability to interpret and apply eligibility criteria and federal/state healthcare regulations
• Basic understanding of EDI (electronic data interchange) in healthcare
• Empathetic, patient-first communication style
• Strong attention to detail and accuracy in data handling
• Analytical thinking and problem-solving for eligibility questions
• Adaptability to regulatory and process changes
• Excellent communication, organizational, technical, and interpersonal skills
• Possesses and demonstrates excellent communication, organizational, technical, and interpersonal skills
• Knowledge of Medicaid and Charity Care eligibility guidelines
• Previous work in a hospital, managed care organization, or insurance company
• Experience enrolling individuals in government or public health programs

Skills

• Certified Application Counselor (CAC) for ACA Marketplace Enrollment
• High school diploma or equivalent required
• Associate’s degree in healthcare administration, public health, or related field preferred
• Bilingual fluency, particularly in Spanish, is highly preferred
• Working knowledge of health insurance terminology and plan structures
• Proficiency in enrollment platforms and data entry systems
• Familiarity with HIPAA and ACA compliance requirements
• Ability to interpret and apply eligibility criteria and federal/state healthcare regulations
• Basic understanding of EDI (electronic data interchange) in healthcare
• Empathetic, patient-first communication style
• Strong attention to detail and accuracy in data handling
• Analytical thinking and problem-solving for eligibility questions
• Adaptability to regulatory and process changes
• Excellent communication, organizational, technical, and interpersonal skills
• Possesses and demonstrates excellent communication, organizational, technical, and interpersonal skills
• Knowledge of Medicaid and Charity Care eligibility guidelines
• Previous work in a hospital, managed care organization, or insurance company
• Experience enrolling individuals in government or public health programs

Benefits

• Competitive salary
• Robst robust benefits with health, dental, Rx and vision plans
• 403b retirement plan options with company match
• Health & Wellness
• Non-Profit Health System – eligible for Federal Student Loan Forgiveness
• PTO, and paid holidays
• Tuition reimbursement
• Employee Assistance Program
• LTD : Long Term Disability
• Life Insurance Options
• Onsite Day care Program
• Available for Per Diem Employees and Part-time Employees working under 20 hours per week
• 403b Company Match not applicable for Per Diem Employees and Part-time Employees working under 20 hours per week

Pay

Salary range provided to comply with New Jersey Law. The rate of pay for each position will be determined based on a variety of factors including the candidate's relevant experience, qualifications, skills, etc.

Schedule

Not specified