Patient Benefits Enrollment Specialist Level 1

Job Details:

Job Location:

415 Columbia Rd - Dorchester, MA 02125, Position Type:
Full Time 30+ hours, Education Level: High School, Salary Range: $18.00 - $25.00 Hourly,

Travel Percentage :
None, Job Category:
Health Care,

Position Title:

Patient Benefits Enrollment Specialist Level I, Department:
Patient Services, Supervisor:
Patient Services Manager, Status / Hours per week:
Full Time / Non-Exempt (40 hours/week)

Pay Range:
The expected base pay for the position is $18-$25 per hour and may be increased based on other factors, such as language, certifications, etc.

The Patient Benefits Enrollment Specialist Level I assists uninsured and under-insured patients in applying for the most comprehensive government-sponsored health insurance coverage they qualify for based on family size, family income, and immigration status. This position also assists patients with selecting and enrolling in an insurance plan, selecting a primary care provider, and setting up premium payments, as applicable.

This position is required to obtain the Massachusetts CAC (Certified Application Counselor) and Certified Navigator Training Certification (for Navigator Grant) within one month of employment and maintain this certification throughout their time in this position.

• Maintains both Certified Application Counselor (CAC) and Navigator Training Certifications (for Navigator Grant).
• Ensures Enrollment Staff are following Sliding Scale Discount Program Policy & Procedures.
• Supports multiple clinical departments, such as Primary Care, Urgent Care, Women’s Health, Behavioral Health, Specialties, including Dental and Eye with their uninsured and under-insured patients seeking services.
• Follows all health center policies and procedures on patient confidentiality/HIPAA and all health center-wide guidelines.
• Verifies patient demographic and insurance information.
• Actively listens to Level 2's & 3's and pays attention to feedback that is given.
• Educates patients on enrollment into the patient electronic record portal system, MyChart.
• Schedules and signs in patients for their Enrollment Appointments.
• Outreaches to patients that do not keep their Enrollment appointments.
• Follows end of day (EOD) procedures for patients that do not show for DNK their Enrollment Appointment.
• Screens patients for basic eligibility into Massachusetts government-sponsored health coverage programs, such as Mass Health, HSN, Health Connector, etc. by checking residency, income and family size.
• Assists patients in completing on-line applications and manually completes the extensive 65 and older Mass Health application.
• Assists patients with the Mass Health re-determination process to minimize any disruptions in coverage through proactive outreach from C3 lists and other sources as well as through patient walk-ins.
• Assists patients with other eligibility programs, such as Medicare Part D Prescription Drug Coverage through research using Medicare’s website; and assists patients with the Medicare and Mass Health Open Enrollment periods.
• Answers patients' inquiries, translates, and completes data entry plus other clerical tasks.
• Educates patients about UCC Enrollment brochure and other services at UCC locations.
• Attends Massachusetts Health Care Training Forum-Webinars.
• Collects and obtains signatures on all patient compliance related documents.
• Outreaches individuals from the C3 ACO Mass Health Redetermination files to assist them in maintaining their eligibility with Mass Health to avoid a gap in coverage.
• Updates insurances in the UCC patient’s EMR.
• Manages returned Enrollment mail by outreaching the patient to obtain an updated address and phone number; updates the EMR and Mass Health contact information.
• Assists patients…