Specialist, Benefit Sales (Facilitated Enroller) In Field - Queens, Ny

Molina Healthcare; Emerald Isle (NC); On-site; USD 25,000 - 58,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a member enrollment specialist in North Carolina to interview, screen and assist potential members with enrollment into Molina health plans. You will process paperwork, provide guidance on plan options, and build relationships with community partners to drive outreach.

Local travel is required and bilingual Spanish/English skills are a plus. The role emphasizes customer service, accuracy, and adherence to HIPAA while supporting enrollment events and follow-ups.

Qualifications

• At least 2 years of health care or customer service experience, including knowledge of health insurance programs.
• Marketplace Certified (CAC) or ability to obtain certification within 30 days of hire.
• Reliable transportation and a valid driver's license with no restrictions.
• Strong interpersonal and communication skills.
• Proficiency with Microsoft Office and data processing.

Responsibilities

• Meets monthly, quarterly, and annual enrollment goals and growth targets.
• Facilitates inbound/outbound calls to interview, screen and assist potential eligible members with enrollment processes into Molina health plans.
• Meets with potential members at various sites within applicable communities.
• Provides education and support to potential members navigating the application process, explaining requirements and providing necessary documentation.
• Identifies and educates potential members on plan features and benefits and completes required disclosures.
• Submits all completed applications by submission deadlines per state requirements and Molina guidelines.
• Assists current members due for recertification by completing annual recertification applications.
• Responds to inquiries from prospective members according to marketing guidelines.
• Attends community health fairs and outreach events; travels locally for enrollment activities.

Skills

Interpersonal skills

Customer service

Attention to detail

Time management

Communication skills

Microsoft Office proficiency

Tools

Microsoft Office

Job description

JOB DESCRIPTION Job Summary

Provides support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Also develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members, and represents at community-based outreach events to aid enrollment efforts.

Essential Job Duties

• Meets monthly, quarterly, and annual member enrollment goals and growth targets.
• Facilitates inbound/outbound calls to interview, screen and assist potential eligible members with enrollment processes into qualified Molina health plans.
• Meets with potential members at various sites within applicable communities.
• Provides education and support to potential members navigating the complex health care system by assisting with the application process, explaining requirements and providing necessary documentation.
• Identifies and educates potential members on all aspects of applicable plans, including answering questions related to plan features and benefits and walking consumers through required disclosures.
• Educates members on options to make premium payments, including due dates.
• Assists members with plan and primary care physician selection.
• Submits all completed applications, adhering to submission deadline dates as imposed by state specific requirements and Molina enrollment guidelines and requirements.
• Identifies and assists current members who are due to recertify health care coverage by completing the annual recertification application, including add-on for additional eligible family members
• Responds to inquiries from prospective members according to marketing guidelines.
• Adheres to health plan rules and regulations as applicable for member enrollment.
• Participates in events and community outreach projects with other agencies as assigned by leadership for a minimum of eight hours per week.
• Establishes and maintains good working relationships with external business partners such as hospital and provider
  organizations, city agencies and community-based organizations where enrollment activities are conducted.
• Develops and strengthens relationships in order to generate new opportunities.
• Attends community health fairs, events and external meetings as required.
• Attends occasional weekend or evening special events as needed.
• Local travel required.

Required Qualifications

• At least 2 years of experience in health care, and/or customer/provider services experience, including at least one year of experience working with state and federal health insurance programs and populations, or equivalent combination of relevant education and experience.
• Marketplace Certified (Valid, unrestricted NYSOH Certified Application Counselor ID - CAC) or ability to obtain certification within 30 days of hire.
• Must have reliable transportation and a valid driver's license with no restrictions.
• Interpersonal/customer service skills.
• Data processing and proofing experience.
• Attention to detail, organizational and time-management skills, and ability to work independently and meet internal deadlines.
• Positive attitude, and ability to adapt to change.
• Knowledge of managed care insurance plans.
• Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills, including strong presentation skills.
• Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

• Previous experience enrolling members into managed care programs/health insurance.
• Bilingual - Spanish and English.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $18.04 - $42.2 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.