Health Insurance Assistant

Role: Health Insurance Assistance Specialist
Duration: 5 Months (Contract)
Location: Nashville TN (Hybrid)

Key Skills: Healthcare Administration and Operations; Health Insurance Enrollment and Eligibility; Customer Service and Technical Assistance; Case Management Support and Coordination; HIPAA Compliance and Confidentiality; Documentation and Issue Resolution

Minimum Required Qualifications
*Eligibility to work in the United States
1. Bachelors degree or Masters degree in Health Administration Public Health Healthcare Management or a closely related field.
2. Minimum of four (4) years of front-facing customer services experience preferably in healthcare public health health insurance or health administration setting.
3. Experience working in a health administration environment with demonstrated knowledge of healthcare operations processes and client service delivery.
4. Proven ability to thoroughly document client interactions research issues conduct appropriate follow-up and bring issues to resolution in a timely manner.
5. Strong problem-solving skills with the ability to analyze complex situations identify solutions and coordinate resolution among multiple priorities and maintaining a high level of accuracy and attention to detail.
6. Ability to work effectively in a moderately-paced environment while managing multiple tasks and maintaining a high level of accuracy and attention to detail.
7. Demonstrated ability to adapt quickly to changing procedures priorities and program requirements.
8. Excellent verbal and written communication skills with the ability to communicate professionally with case managers healthcare professionals Tennessee Dept of Health staff vendors and community partners.
9. Strong organizational and time-management skills.
10. Proficiency in Microsoft Office applications and experience working with databases case management systems or other electronic information systems simultaneously.
11. Ability to maintain confidentiality and comply with all the applicable HIPAA Ryan White Program and organizational requirements.

Preferred Qualifications
1. Experience supporting Ryan White HIV/AIDS Program services AIDS Drug Assistance Programs (ADAP) health insurance enrollment or benefits coordination.
2. Knowledge of HIV care systems medication access programs and healthcare coverage options.
3. Experience providing technical assistance and support to case managers healthcare providers or public health partners.
4. Experience working with state or federally funded healthcare programs.

Essential Duties and Responsibilities

Program Support and Enrollment Assistance
1. Serve as the primary point of contact of Ryan White field case managers seeking real-time assistance with Insurance Assistance Program (IAP) enrollment eligibility renewals and participation.
2. Provide guidance regarding program policies procedures documentation requirements and enrollment processes.
3. Assist with troubleshooting enrollment barriers and resolving issues that may impact clients access to insurance coverage and HIV medications.
4. Ensure accurate and timely communication regarding program updates enrollment requirements and procedural changes.

Client and Case Management Support
1. Collaborate with medical case managers throughout Tennessee to identify and resolve issues affecting HIV/AIDS clients.
2. Support efforts to remove barriers to care and medication access for eligible clients.
3. Research and resolve client-specific concerns while ensuring compliance with program guidelines and confidentiality requirements.
4. Promote a client-centered approach focused on continuity of care and access to treatment.

Partner Collaboration and Issue Resolution
1. Work closely with Tennessee Department of Health partners vendors and manger to resolve complex operational and client-related issues.
2. Escalate and coordinate resolution of cases requiring multi-agency or cross-functional involvement.
3. Assist in identifying systematic issues recurring challenges and emerging trends affecting program operations or client outcomes.
4. Provide feedback and recommendations for process improvements that enhance program efficiency and effectiveness.

Communication and Customer Service
1. Manage a high volume of incoming and outgoing telephone calls and electronic communications.
2. Maintain efficient streamlined and uniform communication with field case managers TDH staff healthcare providers and program partners.
3. Provide professional responsive and solution-focused customer service.
4. Document interactions resolutions and follow-up activities in accordance with established procedures.

Operational Excellence and Quality Improvement
1. Monitor workflows and support efforts to maintain operational excellence across the ADAP program.
2. Assist with quality assurance activities data validation and program monitoring initiatives.
3. Identify opportunities to improve processes communication and service delivery.
4. Participate in meetings trainings and collaborative workgroups to support program goals and continuous improvement efforts.

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Required Experience:

Junior IC