[Hiring] State Programs Facilitated Enroller @company

Role Description

The State Programs Facilitated Enroller is responsible for assisting individuals with enrollment and renewal applications through the NY State of Health marketplace system. This includes:

• Reviewing taxes, payroll stubs, and other income documents.
• Reviewing eligibility within the NY State of Health and EMEDNY systems according to NYS Department of Health (NYSDOH) guidelines.
• Conducting outreach and enrollment calls.
• Working directly with customers over the phone to assist them with renewing applications or completing new applications.
• Assisting with the NY State of Health inquiry process.
• Answering questions regarding specific CDPHP plans offered through NY State of Health.
• Processing member recertification applications, adds, changes, and terminations.
• Handling renewals over the phone and community outreach events.
• Conducting themselves in accordance with regulations and instructions set forth by NYS and the Federal government.
• Meeting all defined CDPHP standards of outreach.

Qualifications

• High school diploma or GED required.
• Marketplace Facilitated Enroller certification or Certified Application Counselor certification required or must be obtained within 30 days of hire.
• Minimum of 1 year employment experience in a health insurance setting required, with experience in Government Programs preferred.
• Demonstrated ability to interpret and make decisions based on corporate underwriting guidelines, as well as State of New York & Federal statutes relating to healthcare administration.
• Demonstrated ability to pro-actively identify problems and recommend and/or implement effective solutions.
• Demonstrated ability to work with and maintain confidential information.
• Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
• Excellent verbal and written communication skills.
• Flexibility to adapt to a changing and fast-paced environment.
• Strong system research and analysis skills; deductive and creative thinking.
• Strong attention to detail and capability to meet established productivity and quality standards.
• Demonstrated ability to effectively manage time with multiple task assignments.
• Ability to speak Spanish or another language preferable.

Requirements

• Perform all duties and assignments in compliance with corporate and department performance standards and agreements.
• Work closely with all team members to ensure the team meets all established goals for accuracy, timeliness, and customer satisfaction.
• Assist with inbound calls and scheduling enrollment appointments as needed.
• Ensure confidentiality of all data in compliance with department and Plan confidentiality policies.
• Communicate the goals and processes of State Programs effectively and efficiently both internally and externally.
• Comply with CDPHP’s Corporate Compliance Policy and report any suspected violations.
• Be available for after-hours events as needed.

Benefits

• Participation in group health and/or dental insurance.
• Retirement plan.
• Wellness program.
• Paid time away from work.
• Paid holidays.