Outreach and Enrollment Specialist

Position Overview :

This role is essential in ensuring that patients and community members receive the support they need with Medicaid and Marketplace applications.

It involves direct engagement with individuals to guide them through the application process and collaborate closely with the front desk staff and billing department.

The goal is to ensure the correct insurance information is accurately maintained in the EMR system. As a key part of the clinic's front-end team, this role requires leading with compassion and care to provide a positive and supportive experience for all patients.

Duties and Responsibilities :

• Participates in in-clinic and outreach services, outreach, and enrollment strategies, such as working with community partners during open enrollment.
• Collect co-payments, and past balances, generate Good Faith Estimates pertaining to the sliding fee schedule and finance policies.

Point person to ensure co-payment reason codes are entered for inability to pay.

• Oversee the front-end cash drawer has appropriate documentation on payments received.
• Remain up to date and maintain eligibility criteria, as it applies to the various insurance coverage plans. Ensuring insurance plans within patient EMR records are current.
• Coordinate with restrictive insurance programs, serving as a point person to navigate appropriate or resolve restriction limitations.
• Provide application assistance to patients and other persons experiencing homelessness within the community.
• Work Collaboratively with the community partners on enrollment into available insurance programs.
• Participate in program plans and grant expectations as indicated in relevant work plans and reporting criteria, and assist in compiling reports, data, and enrollment information as required for grants and audits.
• Collect and track required information on outreach and enrollment activities to comply with reports, grants, and other required outcome-driven projects.
• Conduct one-on-one and family education on topics such as public program eligibility, benefits, and the importance of health care coverage.

Point person in accessing Medicaid Lookup Tool and Noridian.

• Provide referrals to clinic services and community resources to improve patients' quality of life.
• Provide basic clinic information in a fair, accurate, impartial, and culturally sensitive manner.

Qualifications & Competencies :

Required :

• High School Diploma or GED equivalent
• 1-2 years or more customer service experience
• Strong communication, both written and verbal
• Strong time management and organizational skills

Preferred :

• Prior knowledge of EMR systems
• Spanish speaking
• Expertise in conflict resolution
• Medicaid and Marketplace experience

Work Environment :

This role is based at our main location in Downtown Salt Lake City, with standard working hours from Monday to Friday, 8 am to 6 pm.

There may be occasional requirements for evening or weekend work. Additionally, the role may involve traveling to Homeless Resource Centers and other outreach locations throughout the valley to support community initiatives.

Must be able to pass a background check, including fingerprints.

Job Posted by ApplicantPro