Enrollment Counselor

Lone Star Circle of Care; Round Rock (TX); On-site; USD 36,000 - 56,000; Full time

Benefits offered by this job

Medical, Dental, and Vision insurance

403b Employee Retirement Plan

Paid Time Off

Job summary

Lone Star Circle of Care is seeking an Enrollment Counselor to help individuals and families access health care coverage through the Health Insurance Marketplace and Medicaid/CHIP programs. You will screen eligibility, explain options, and guide clients through the enrollment process with face-to-face support across LSCC facilities.

Ideal candidates have strong customer service skills, bilingual English/Spanish, and at least two years in eligibility determination or related health services.

Qualifications

• High school diploma or GED is required.
• Associates degree preferred in health services or related field.
• Minimum of two years of experience in program eligibility determination or health and human services work.
• Bilingual English/Spanish language skills preferred.

Responsibilities

• Provide non-biased information on coverage options and benefits.
• Assist and complete enrollment applications.
• Verify documents and information via calls for face-to-face appointments.
• Handle program registrations to ensure accurate screening and enrollment outcomes.
• Identify programs for which patients may be eligible using verification tools.
• Maintain patient documentation in VeritySource, Athena, and other systems.

Skills

Bilingual English/Spanish

Eligibility determination experience

Customer service

Problem solving

Education

High school diploma or GED

Associates degree

Job description

We are seeking a Enrollment Counselor who is passionate about making a difference in our community. At Lone Star Circle of Care (LSCC) we strive for exceptional, equitable patient care that leads to healthier communities. Our Enrollment Counselors support individuals and families in obtaining health care coverage by facilitating enrollment in insurance programs through the federal Health Insurance Marketplace and other health care safety net programs, including Medicaid and CHIP. This role is responsible for screening individuals and patients to determine eligibility for benefits and financial assistance, educating them on available coverage options, and guiding them in making informed decisions when selecting qualified health plans. The Enrollment Counselor provides face-to-face assistance throughout the application and enrollment process and conducts outreach activities to increase community awareness of insurance affordability programs, LSCC's program registration, and comprehensive primary care services. This position requires the ability to build and maintain professional relationships at all levels of the organization, deliver excellent customer service, and float to LSCC facilities as needed. If you have the ambition and desire to work in a friendly and fun environment, LSCC is the place for you!

A Day in the Life of a Enrollment Counselor may look like this:

• Provides non-biased information regarding available coverage options and benefits
• Fills out or helps to fill out appropriate application
• Verifies documents and information gathered telephonically by Program Advisors when patient presents for face-to-face appointments
• Receives scheduled and unscheduled calls through Patient Navigation Center and face-to-face encounters at clinical and other settings to conduct various Program Registration functions
• Performs program registration thoroughly to ensure highly accurate screening and enrollment outcomes for the federal Health Insurance Marketplace, health care safety net programs, and LSCC Sliding Fee Scale assignment
• Accurately identifies programs for which patient may be eligible
• Using VeritySource, Athena, and available insurance verification programs and other automated tools, maintains all patient documentation necessary to complete assignments and certify clients/patients in the appropriate programs
• Acquires and maintains knowledge and expertise in eligibility, enrollment, and program specifications of the federal Marketplace and other programs such as Medicaid and CHIP

We ask our Enrollment Counselors to possess a minimum of:

• High school diploma or GED

The following experience/skills are preferred:

• Associates degree
• Minimum of two (2) years of experience in program eligibility determination or related health and human services work.
• Bilingual English/Spanish language skills

Key Success Factors

Some key factors that will make an individual successful in this role:

• The ability to problem solve
• Organizational skills
• Attention to detail
• Team player personality
• Time management

Benefits

LSCC offers a competitive benefits package, including:

• Competitive salary;
• Medical, Dental, and Vision insurance;
• LSCC paid Life insurance;
• LSCC paid Short-Term and Long-Term Disability insurance;
• Paid Time Off; and
• 403b Employee Retirement Plan

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