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Centene

Runs government-backed health insurance plans

Field Health Benefit Representative - Facilitated Enroller

Customer Education & TrainingConfirmed live in the last 24 hours
Full-timeUtica, NY, USA$23.23 - $39.61 /hr

About the Job

Requirements

  • A high school diploma or GED is required.
  • Basic computer skills are required.
  • Prior public speaking experience is required.
  • For non-New York City counties, a driver's license is mandatory; it is preferred for New York City counties.
  • 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 requirements.
  • Must meet annual Marketplace Facilitated Enroller recertification requirements.
  • Must be authorized to work in the United States without current or future employment-based visa sponsorship.
  • Must work evenings and weekends.
  • Must comply with conflict-of-interest standards and regulations.
  • Must safeguard confidential information and protected health information in compliance with 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 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 how to use Fidelis digital tools, including the member portal and mobile app.
  • Describe plan features, benefits, and cost-sharing mechanisms, including deductibles, copayments, and coinsurance, and explain their effects on consumers.
  • Explain Marketplace metal tiers and how benefits vary by income level.
  • Assist consumers in submitting required documents by scan, fax, or mail.
  • Support existing members with renewals and recertifications.
  • Help consumers submit premium payments when required.
  • Provide culturally and linguistically appropriate assistance to the population served.
  • Conduct public education activities and presentations about Fidelis Care products and Marketplace options.
  • Participate in Affordable Care Act forums, workshops, and community events as requested.
  • Maintain a daily tracking tool with detailed representative activity.
  • Monitor applications in a personal dashboard to ensure timely and accurate applicant follow-through.
  • Review the personal dashboard daily and follow up on potential leads from consumers seeking assistance.
  • Keep current on Marketplace functionalities to effectively manage individual accounts.
  • Follow up on new potential enrollment leads and consumer inquiries, and record dispositions promptly and accurately in the required customer relationship management system.
  • Enter applicant demographic, enrollment-site, and primary-care-provider selection data in the required customer relationship management system during the initial enrollment encounter.
  • Participate in trainings, updates, webinars, and other forums needed to perform the role.
  • Keep current on industry and regulatory updates related to the Affordable Care Act and Marketplace.

Desired Qualifications

  • Two or more years of prior experience in managed care, sales, customer service, or related experience 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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