Healthcare Insurance Navigator & Enrollment Specialist

Rate of Pay: $27 per hour. WCDC provides medical, dental, and vision insurance; PTO, paid holidays, jury duty, and bereavement leave; a 401(k) retirement plan; short‑term and long‑term disability; an Employee Assistance Program (EAP); a quarterly incentive program; and tribal‑discretion COLA adjustments.

Reports to:Member Services Manager

The Insurance Navigation Specialist supports members in accessing affordable healthcare by assisting with financial aid applications, insurance enrollment, coverage navigation, and healthcare advocacy. This role serves as a key resource for members, providers, and clinic staff by ensuring accurate patient financial and insurance information and helping individuals maximize healthcare benefits and resources.

• Receive, review, and process all financial aid applications to ensure completeness and accuracy.
• Assist members in gathering and submitting required documentation for financial aid and insurance applications.
• Collaborate with counselors, peer support staff, and other team members to obtain necessary verification documents.
• Monitor application status and communicate updates to patients as needed.

• Assist individuals with health coverage application processes, including Medicaid and Health Insurance Marketplace enrollment.
• Review eligibility determinations and provide guidance on enrollment options.
• Educate members on insurance requirements, benefits, and available coverage options.
• Support members with maintaining active insurance coverage and resolving enrollment-related issues.

• Review member accounts and insurance profiles to ensure accurate demographic, financial, and coverage information.
• Identify and resolve discrepancies that may impact claims processing, billing, or eligibility.
• Maintain accurate documentation in electronic health record systems
• Assist members in navigating Medicaid and other insurance-related concerns, including coverage, benefits, summaries of benefits, and eligibility requirements.
• Serve as a member advocate by assisting with the resolution of medical billing issues both within the organization and with our referral partners
• Guide members through complex healthcare systems and connect them with appropriate community and healthcare resources.

• Serve as a subject matter resource for providers, clinical staff, and administrative teams regarding insurance-related questions.
• Collaborate with interdisciplinary teams to coordinate member support services and address barriers to care.
• Stay informed about changes in Medicaid, Marketplace plans, and financial assistance programs.

• High school diploma or GED required.
• Minimum 2 years of experience in insurance navigation, financial counseling, patient financial services, healthcare access, or a related field.
• Working knowledge of Medicaid, Health Insurance Marketplace plans, and healthcare financial assistance programs.
• Experience assisting individuals with application processes, eligibility determination, and documentation requirements.
• Strong customer service, communication, and problem-solving skills.
• Proficiency with electronic health records (EHRs) and Microsoft Office applications.
• Ability to