State Programs Facilitated Enroller

About the role

The State Programs Facilitated Enroller is responsible for assisting individuals with enrollment and renewal applications through the NY State of Health marketplace system. This includes reviewing taxes, payroll stubs, and other income documents and reviewing eligibility within the NY State of Health and EMEDNY systems according to NYS Department of Health (NYSDOH) guidelines. The State Programs Facilitated Enroller duties will also include conducting outreach and enrollment calls, working directly with customers over the phone to assist them with renewing their applications or completing new applications as permitted by the state, assisting with the NY State of Health inquiry process, answering questions regarding specific CDPHP plans offered through NY State of Health, processing member recertification applications, adds, changes and terminations. The candidate will also handle renewals over the phone, and as needed, community outreach events, or other questions related to enrollment. All Facilitated Enrollers must conduct themselves in accordance with regulations and instruction set forth by NYS and the Federal government and are expected to meet all defined CDPHP standards of outreach.

Responsibilities

• As a State Programs Facilitated Enroller, the primary responsibility is assisting members in renewing coverage through the NY State Health, including any inquiries in that process, with recertification applications, assisting with changes to their application, and providing general information about the program over the phone.
• Point of contact for the resolution of all inquiries received via phone calls, emails, or other written correspondence regarding enrollment in the NY State of Health. This includes, but is not limited to, making outbound calls to investigate or retrieve missing or incomplete information.
• Act as principal interface with the customer on the telephone for enrollment and renewals in State Programs.
• Effectively deliver enrollment verification information via approved scripting, including, but not limited to discussing the use of the plan identification card, provider network, and prescription program, if applicable.
• Assist prospective members with inquiries on and enrolling into individual off-exchange health plans directly with CDPHP.
• Maintain appropriate standards of outreach to new and existing members to contribute to the growth of membership.
• Work with and have a comprehensive understanding of Facets, E