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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-timeNo salary listed

About the Job

Requirements

  • Must be authorized to work in the United States without employment-based visa sponsorship now or in the future.
  • 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 requirements.
  • Must meet the annual Marketplace Facilitated Enroller recertification requirements.
  • Must work evenings and weekends.
  • Must comply with conflict-of-interest standards and regulations.
  • Must safeguard confidential information and protected health information from unauthorized access and comply with privacy and security standards.

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 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 how these 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 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 Affordable Care Act 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 applicant follow-through.
  • Review the personal dashboard daily and address and follow up on potential leads from consumers seeking assistance.
  • Keep abreast of Marketplace functionalities to effectively manage individual accounts.
  • Follow up on new potential enrollment leads and consumer inquiries.
  • Record all follow-up dispositions promptly and accurately in the required customer relationship management system.
  • Enter applicant demographic, enrollment site, and primary care provider selection data into the required customer relationship management system during the initial enrollment encounter.
  • Participate in trainings, updates, webinars, and other forums needed to carry out the role.
  • Keep abreast of industry and regulatory updates related to the Affordable Care Act and Marketplace.
  • Maintain discretion regarding business-related files, reports, and conversations in accordance with applicable state and federal statutes and regulations.
  • Perform other assigned duties and comply with applicable policies and standards.

Desired Qualifications

  • Two or more years of prior experience in managed care, sales, customer service, or related experience.
  • A driver's license is preferred for New York City counties and mandatory for non-New York City counties.
  • Fluency in Cantonese and/or Mandarin.

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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