Healthcare Navigator

Saint James Health; Newark (NJ); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

403b

Health, Dental and Vision insurance

Paid time off

Sick time

Job summary

Saint James Health is seeking a Healthcare Navigator to assist patients and community residents with enrollment in Medicaid, CHIP, and Federal Marketplace programs. You will conduct outreach, educate clients on affordable options, and help with enrollment applications while staying current on eligibility rules.

The role requires attention to detail, strong time management, and proficiency with Microsoft Office.

Qualifications

• Exchange Enrollment Facilitator Certificate or training within 30 days.
• 3+ years of Healthcare Insurance Enrollment experience preferred.
• Strong attention to detail.
• Efficient with time management.
• Excellent analytical and problem-solving skills.
• Proficient Microsoft Office skills, especially with Excel.
• Complete all related training and certifications.

Responsibilities

• Provide eligibility and enrollment assistance for Medicaid, CHIP, and Federal Marketplace programs to patients and community residents.
• Conduct outreach and education on affordable insurance options and Marketplace.
• Stay current on regulatory guidelines, plan eligibility, and system requirements.
• Assist individuals with enrollment applications and understanding eligibility for individual plans.
• Collaborate with case management to improve communication, reimbursement, and processes.
• Attend community events and health fairs as required by the organization.

Skills

Enrollment expertise

Attention to detail

Time management

Analytical skills

Excel

Education

Exchange Enrollment Facilitator Certificate

Tools

Microsoft Office

Excel

Job description

Position Summary

The Healthcare Navigator is responsible for providing eligibility and enrollment assistance for the Medicaid, CHIP, and Federal Marketplace health insurance programs to patients of the health center and community residents.

• The Healthcare Navigator will conduct outreach activities; and will provide education to existing health center patients and non-health center patients about affordable insurance options and Marketplace.
• Maintains expertise in eligibility, enrollment, and program specifications and conducts public education activities to raise awareness about the Marketplace.
• Assists individuals with enrollment applications and understanding of eligibility for individual plans.
• Stay abreast of regulatory guidelines and insurance plan eligibility, authorization, and system requirements.
• Resolves any remaining issues such as needing providing documentation to maintain eligibility or any enrollment issues with the health insurance companies and help them enroll.
• Collaborates with the Case Management team to create patient-centered communication to improve performance, reimbursement and streamline processes.
• Attends community outreach events, health fairs and informational forums as required by the organization.
• Assists in tracking enrollment metrics and patient payments.
• Monitor and efficiently reconcile electronic work queues.
• Provides support and assistance with financial reports, projects and audits as required.
• Act as a resource/point person for the registration and clinical support teams.
• Perform all duties as assigned.

Position Summary

The Healthcare Navigator is responsible for providing eligibility and enrollment assistance for the Medicaid, CHIP, and Federal Marketplace health insurance programs to patients of the health center and community residents.

Essential Duties And Responsibilities

• The Healthcare Navigator will conduct outreach activities; and will provide education to existing health center patients and non-health center patients about affordable insurance options and Marketplace.
• Maintains expertise in eligibility, enrollment, and program specifications and conducts public education activities to raise awareness about the Marketplace.
• Assists individuals with enrollment applications and understanding of eligibility for individual plans.
• Stay abreast of regulatory guidelines and insurance plan eligibility, authorization, and system requirements.
• Resolves any remaining issues such as needing providing documentation to maintain eligibility or any enrollment issues with the health insurance companies and help them enroll.
• Collaborates with the Case Management team to create patient-centered communication to improve performance, reimbursement and streamline processes.
• Attends community outreach events, health fairs and informational forums as required by the organization.
• Assists in tracking enrollment metrics and patient payments.
• Monitor and efficiently reconcile electronic work queues.
• Provides support and assistance with financial reports, projects and audits as required.
• Act as a resource/point person for the registration and clinical support teams.
• Perform all duties as assigned.

Qualifications

• Required: Exchange Enrollment Facilitator Certificate or complete training within 30 days.
• 3+ years of Healthcare Insurance Enrollment experience preferred.
• Strong attention to detail
• Efficient with time management
• Excellent analytical and problem-solving skills.
• Proficient Microsoft Office skills, especially with Excel
• Complete all related training and certifications.

Benefits

• 403b
• Health, Dental and Vision insurance
• Paid time off
• Sick time

Schedule

• Full-Time (5 days)
• Work locations are subject to change.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit, stand, and walk. The employee must be able to lift and/or move up to ten pounds.

Work Environment

The work environment characteristics described here are representative of those which an employee may encounter while performing the essential functions of this job. While in clinic, there may be some exposure to communicable disease, body fluids, toxic substances, medicinal preparations, and other conditions common to a clinical environment. The noise level in the varies from moderate to loud.