Position Summary

The Patient Enrollment and Access Specialist will coordinate financial assessments of patients, bridge enrollment to Impanelment, and assist with clinical access for PrimeCare clients.

Duties and Responsibilities

• Provide enrollment assistance (including, but not limited to, completing coverage applications, gathering required documentation, and troubleshooting the enrollment process) for uninsured children and adults to access subsidized, low-cost, and free health insurance programs through the Health Insurance Marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP).
• Enroll patients in Snap benefits and Cash Assistance, through DHS.
• Provide structured patient education on health coverage, engage in follow-up conversations, and offer renewal assistance for enrolled individuals.
• Enroll patients in, and maintain, PrimeCareHealth’s Financial Assistance program.
• Assist in re-determination process for MCO members.
• Ensure continuity of insurance eligibility to identify patients with current breaks in coverage.
• Impanel of patients to medical home provider, based on direction from Manager of Enrollment,
• Maintain health plan enrollment roster information, patient utilization history, and provider-weighted panel size, and patient preference, medical home provider panels.
• Impanel new patients to provider panels in Athena by assigning a PCP relationship and following the weighted-panel guidelines for assignment.
• Distribute outreach materials to patients to build coverage option awareness.
• Work with patients and billing staff to troubleshoot and resolve billing issues.
• Other duties as assigned.

Required Skills or Abilities

• Knowledge of the health and human services infrastructure, health insurance programs, and public coverage options.
• Ability to effectively develop and nurture relationships with a diverse group of stakeholders and communicate with potential enrollees.
• Ability to work independently and coordinate multiple tasks.
• Strong computer skills with proficiency in Outlook, Word, PowerPoint, Excel, internet-based applications, and the Microsoft operating system.

Physical Demands

• Must be able to remain in a stationary position 50% of the time.
• Must be able to move around the clinic site 50% of the time.
• Constantly operates a computer, computer printer, copy machine, and telephone.
• Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
• Must be able to transport from one site to another.
• Must be able to cover other shifts as necessary.

Required Knowledge, Experience, or Licensure/Registration

• Bilingual highly desirable. Polish/English or Spanish/English preferred.
• Bachelor's Degree in Public Health, Health Education, Social Work or related field strongly preferred.
• Experience working with large and/or diverse client populations and low-income families and individuals.
• Excellent interpersonal, verbal, and written communication skills.
• Excellent time management, organizational, and intermediate to advanced computer skills; fast learning ability to use new technologies and systems.
• Committed to achieving results under demanding time frames.
• Strong ability to manage and meet multiple deadlines and goals, and maintain documentation, according to required state and federal laws and regulations.
• May require some non-traditional hours, including limited evening and weekend hours.