Specialist, Benefit Sales-Fully bilingual Spanish-Buffalo, NY

Molina Healthcare, Inc.; Buffalo (NY); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare, Inc. in Buffalo, NY is seeking a Health Enrollment Specialist to support member enrollment activities, interview and screen eligible members, assist with plan selection, and ensure documentation accuracy.

You will build relationships with local community agencies, travel locally, and participate in outreach events to aid enrollment. Requirements include 2+ years in health care or related fields, NYSOH CAC certification or ability to obtain, and strong communication.

Qualifications

• At least 2 years of experience in health care and/or customer/provider services, including at least one year of experience with state and federal health insurance programs.
• Marketplace Certified (NYSOH 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 deadlines.
• Positive attitude and adaptability to change.
• Knowledge of managed care insurance plans.
• Ability to work with diverse populations.
• Ability to maintain confidentiality per HIPAA.
• Ability to establish positive working relationships with coworkers, members, providers, and customers.
• Effective verbal and written communication skills; proficient in Microsoft Office and related software.

Responsibilities

• Meets enrollment goals and growth targets.
• Facilitates inbound/outbound calls to interview and assist with enrollment into Molina health plans.
• Meets with potential members at various sites within communities.
• Educates potential members on enrollment requirements and plan features.
• Assists with plan and PCP selection and premium payments.
• Submits applications by state-imposed deadlines.
• Assists with annual recertification of coverage.
• Responds to inquiries per marketing guidelines.
• Attends community events and outreach projects; travels locally.

Skills

Healthcare exp

Customer service

HIPAA knowledge

Interpersonal skills

Data entry

Attention to detail

Time management

Communication

MS Office

Tools

MS Office Suite

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