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Centene

Runs government-backed health insurance plans

Field Health Benefit Representative - Facilitated Enroller

Case Management & AdvocacyConfirmed live in the last 24 hours
Full-timeOnondaga County, NY, USA$23.23 - $39.61 /hr

About the Job

Requirements

  • Must have a high school diploma or GED.
  • Must have basic computer skills.
  • Must have prior public speaking experience.
  • Must complete and pass the New York State of Health-approved training program and become certified.
  • Must complete all required annual recertification courses and learning activities.
  • Must meet annual Marketplace Facilitated Enroller recertification requirements.
  • Must be authorized to work in the United States without employment-based visa sponsorship now or in the future.
  • Must work evenings and weekends.
  • Must have a driver's license for non-New York City counties; a driver's license is preferred for New York City counties.

Responsibilities

  • Educate and assist individuals with enrolling in coverage through the New York State of Health Marketplace, including Medicaid, Child Health Plus, Essential Plan, Qualified Health Plans, and Health & Recovery Plan.
  • Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
  • Teach members about Fidelis digital tools, including the member portal and mobile app.
  • Describe plan features, benefits, and cost-sharing mechanisms, including deductibles, co-pays, and co-insurance, and explain how they affect consumers.
  • Explain Marketplace metal tiers and how benefits vary by income level.
  • Assist consumers with submitting required documents via scan, fax, or mail.
  • Support existing members with renewals and recertifications.
  • Help consumers with premium payment submissions when required.
  • Provide culturally and linguistically appropriate assistance to the population served by the Marketplace.
  • Conduct public education activities and presentations to raise awareness of Fidelis Care products and Marketplace options.
  • Participate in ACA forums, workshops, and community events as requested.
  • Maintain a daily tracking tool containing detailed representative activity.
  • Monitor all applications in the personal dashboard to ensure timely and accurate follow-through from applicants.
  • Review the personal dashboard daily to address and follow up on potential leads for consumers seeking assistance.
  • Keep abreast of Marketplace functionalities to effectively manage individual accounts.
  • Follow up on new potential enrollment leads and consumer inquiries, and record dispositions accurately and promptly in the required CRM.
  • Enter applicant demographic, enrollment site, and PCP selection data in the required CRM during the initial enrollment encounter.
  • Comply with conflict-of-interest standards and regulations.
  • Safeguard confidential information and protected health information from unauthorized access, in compliance with privacy and security standards.
  • Participate in trainings, updates, webinars, and other forums necessary to carry out the role.
  • Keep abreast of industry and regulatory updates pertaining to the ACA and Marketplace.
  • Maintain discretion regarding business-related files, reports, and conversations in accordance with applicable state and federal statutes and regulations.
  • Perform other assigned tasks and duties and comply with applicable policies and standards.

Desired Qualifications

  • Two or more years of prior experience in managed care, sales, customer service, or a related area is preferred.
  • Fluency in a second language is highly preferred.
  • A driver's license is preferred for New York City counties.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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