Healthcare Navigator

at  Saint James Health Inc

POSITION SUMMARY:

The Healthcare Navigator is responsible for providing eligibility and enrollment assistance for the Medicaid, CHIP, and Federal Marketplace health insurance programs to patients of the health center and community residents.

QUALIFICATIONS:

• Required: Exchange Enrollment Facilitator Certificate or complete training within 30 days.
• 3+ years of Healthcare Insurance Enrollment experience preferred.
• Strong attention to detail
• Efficient with time management
• Excellent analytical and problem-solving skills.
• Proficient Microsoft Office skills, especially with Excel
• Complete all related training and certifications.

• The Health Insurance Navigator will conduct outreach activities; and will provide education to existing health center patients and non-health center patients about affordable insurance options and Marketplace.
• Maintains expertise in eligibility, enrollment, and program specifications and conducts public education activities to raise awareness about the Marketplace.
• Assists individuals with enrollment applications and understanding of eligibility for individual plans.
• Stay abreast of regulatory guidelines and insurance plan eligibility, authorization, and system requirements.
• Resolves any remaining issues such as needing providing documentation to maintain eligibility or any enrollment issues with the health insurance companies and help them enroll.
• Collaborates with the Case Management team to create patient-centered communication to improve performance, reimbursement and streamline processes.
• Attends community outreach events, health fairs and informational forums as required by the organization.
• Assists in tracking enrollment metrics and patient payments.
• Monitor and efficiently reconcile electronic work queues.
• Provides support and assistance with financial reports, projects and audits as required.
• Act as a resource/point person for the registration and clinical support teams.
• Perform all duties as assigned.