Insurance Enrollment Community Health Worker; IE CHW

Insurance Enrollment Community Health Worker (IE CHW)

Reports to:

Insurance Eligibility Specialist

Status:
Non-Exempt (Hourly $19.00 - $25.00)

Job Purpose:

The Insurance Enrollment Community Health Worker (IE CHW) plays a crucial role in the healthcare system. The primary responsibility is to guide individuals through the insurance enrollment process. The Insurance Enrollment Specialist will handle applications, collect information, provide advice, and determine the patients' eligibility for insurance coverage and other enabling programs. The IE CHW will be skilled at assessing and screening patients for specific KS Medicaid, Medicare and Marketplace plans and programs.

They will be able to make recommendations, help patients navigate the enrollment process and maintain meticulous records. An outstanding candidate will demonstrate exceptional communication skills and detail-oriented work. This role demands strong interpersonal skills, attention to detail, organization, and the ability to navigate complex information while providing excellent customer service. This role will also offer healthcare system education to help families know how to utilize their benefits and access Heartlands integrated services as well as other service providers.

The IE CHW will also provide additional social service resources to improve their daily lives and mitigate barriers to care. The Insurance Enrollment CHW provides unbiased enrollment assistance and community outreach.

• Customer Guidance:
  They assist individuals in understanding the enrollment requirements, procedures, and options available. This involves explaining eligibility criteria, application processes, and required documentation.
• Resource Navigation:
  The IE CHW will evaluate other unmet needs and work to connect patients with resources such as food pantries, employer assistance programs and utility assistance.
• Application Processing:
  They collect, review, and process enrollment applications, ensuring all necessary information is complete and accurate. This may involve data entry, verification, and coordination with other departments or agencies. The IE CHW will help patients determine what health insurance programs they are eligible for and walk patients through the application process.
• Communication:
  Enrollment CHWs serve as a point of contact for inquiries, providing information via phone, email, or in-person meetings. Clear communication about deadlines, requirements, and procedures is essential.
• Education:
  
  Health insurance and using health care services can be confusing. The IE CHW will provide one-on-one and group education about health insurance along with how to access care. The IE CHW may also provide outreach and education at community sites and agencies, health fairs and events. Increasing awareness among the remaining uninsured about the coverage options available to them, helping consumers find affordable coverage that meets their needs
• Compliance and Regulations:
  They must stay updated on relevant regulations, policies, and compliance standards to ensure adherence to legal requirements throughout the enrollment process.
• Problem Resolution:
  Addressing issues that arise during enrollment, such as missing information, discrepancies, or technical problems, is a significant part of the role. They work to resolve these efficiently and effectively.
• Documentation and Reporting:
  Maintaining accurate records, generating reports, and tracking enrollment data is often part of the responsibilities. This helps in assessing enrollment trends and identifying areas for improvement. Documents pertinent information in electronic medical record.
• Collaboration:
  
  Enrollment CHWs may collaborate with other departments, such as front…