C

Centene

Runs government-backed health insurance plans

Field Health Benefit Representative - Facilitated Enroller

Customer Education & TrainingPosted on Nov 11
Full-timeBuffalo, 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 required annual recertification courses and learning requirements.
  • Must meet annual Marketplace Facilitated Enroller recertification requirements.
  • Must work evenings and weekends as required.
  • Must have a driver's license for non-New York City counties; a driver's license is preferred for New York City counties.
  • Must comply with conflict-of-interest standards and regulations and protect confidential information, including Protected Health Information, in accordance with applicable privacy and security standards.
  • Must maintain discretion regarding business-related files, reports, and conversations in accordance with applicable state and federal statutes and regulations.

Responsibilities

  • Educate and assist individuals with enrolling in coverage through the New York State of Health Marketplace, including Medicaid, Child Health Plus, the Essential Plan, Qualified Health Plans, and Health & Recovery Plans.
  • Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
  • Teach members how to use 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 by scan, fax, or mail.
  • Support existing members with renewals and recertifications.
  • Help consumers submit premium payments when required.
  • Provide information and assistance in a culturally and linguistically appropriate manner for the population being served.
  • 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 with detailed representative activity.
  • Monitor applications in the personal dashboard to ensure timely and accurate applicant follow-through.
  • Review the personal dashboard daily and address and follow up on potential leads from consumers seeking assistance.
  • Keep current with Marketplace functionalities to manage individual accounts effectively.
  • Follow up on new potential enrollment leads and consumer inquiries, recording dispositions accurately and promptly in the required CRM.
  • Enter applicant demographic, enrollment-site, and primary care provider selection data in the required CRM during the initial enrollment encounter.
  • Participate in trainings, updates, webinars, and other forums needed to carry out the role.
  • Keep current with industry and regulatory updates concerning the Affordable Care Act and Marketplace.
  • Perform other duties as assigned and comply with applicable policies and standards.

Desired Qualifications

  • Two or more years of experience in managed care, sales, customer service, or related work.
  • Bilingual ability in English and Bengali, Hindi, Urdu, Gujarati, or Arabic.
  • Customer service experience.
  • Community outreach and engagement experience.
  • Front-facing, customer-focused sales experience.
  • Field sales experience.
  • Prospecting, tabling, and event participation experience.
  • Proficiency in Microsoft Office Suite.
  • Experience with Salesforce CRM.
  • A driver's license 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

Recently Posted Jobs

Explore more opportunities at Centene

See more jobs