Insurance Navigator

Job Description

Job Description

Mon-Fri 8a-5p

The posted wage range reflects the full range for this role. Placement within the range is based on job-related factors, and new hires typically start below the midpoint.

"Ensuring Safety Excellence: In compliance with Washington State's ESSB 5123, we prioritize safety in our workforce by conducting controlled substance testing, including marijuana, for this position, which is deemed safety-sensitive.”

Make a Difference Every Day!

Help individuals access the healthcare they need by guiding them through insurance enrollment, renewals, and coverage options with clarity and compassion. As an Insurance Navigator, you play a critical role in removing barriers to care while ensuring accuracy, compliance, and continuous coverage for those we serve.

Our Ideal Co-Worker

Our ideal co-worker is compassionate, team-oriented, and committed to the people we serve. You communicate openly, support your colleagues, and bring curiosity, accountability, and respect to your work. You value collaboration over competition and believe recovery is possible for everyone.

What Sets Us Apart

As one of Washington’s longest-running providers, we offer a true continuum of care—from treatment and outpatient services to recovery housing and long-term support. Our integrated, wrap-around model allows staff to gain diverse experience while helping clients build stable, sustainable lives in

recovery.

Why Our Staff Love Working Here

Staff find deep fulfillment in witnessing real transformations: people regaining confidence, reconnecting with family, and rediscovering hope. Whether through lived experience or professional passion, our team shares a purpose-driven commitment to making a meaningful difference every day.

Benefits That Support You

We invest in our team with medical, dental, and vision coverage, a supportive and values-driven culture, paid time off that starts accruing on day one, and much more—because caring for yourself is essential to caring for others.

Position Summary:

The Insurance Navigator assists persons served in accessing and maintaining health insurance coverage, with a focus on Washington Apple Health (Medicaid) and Washington Healthplanfinder programs. This role provides fair, accurate, and impartial enrollment assistance, eligibility screening, and benefits education while collaborating with internal teams and external partners to prevent coverage gaps. The position requires Washington State–mandated Navigator certification and ongoing training to ensure compliance with privacy, enrollment, and consumer assistance standards.

CORE COMPETENCIES

Collaborates with Others

Collaborating cohesively and in a helpful manner to accomplish shared objectives alongside peers.

• Recognizes and honors the contributions and hard work of others.
• Offers valuable and actionable feedback to peers in a constructive and professional manner.

Acting with Empathy and Compassion

Genuinely understand and respect for others' perspectives and emotions. Strive to foster a culture of compassion, empathy, and support that extends beyond our walls.

• Maintains open and effective communication channels with team members.
• Stays open, curious, and flexible to suspend judgments and evaluations when considering what others offer.

RESPONSIBLITIES

• Conduct eligibility screenings to determine appropriate insurance options for persons served.
• Assist persons served in understanding and enrolling in Washington Apple Health (Medicaid), Washington Healthplanfinder Qualified Health Plans, and other applicable coverage programs, including renewals and redeterminations.
• Help persons served complete applications, renewals, and required documentation for insurance enrollment.
• Verify insurance eligibility, benefits, and managed care enrollment prior to service initiation.
• Provide education to persons served regarding insurance benefits, cost-sharing responsibilities, and covered services.
• Serve as a liaison between persons served and managed care organizations to resolve coverage issues or disputes.
• Monitor renewal and redetermination dates and proactively prevent coverage lapses.
• Maintain accurate records of interactions, enrollment status, and follow-up activities.
• Safeguard protected health information in compliance with HIPAA and 42 CFR Part 2.
• Complete all Exchange-mandated continuing education and quarterly training updates related to Washington Healthplanfinder, Apple Health (Medicaid), Qualified Health Plans, and special enrollment policies.
• Collaborate with healthcare providers, managed care organizations, community partners, and social service agencies, and participate in outreach efforts to improve insurance access, enrollment continuity, and support the needs of persons served.
• Provide fair, accurate, and impartial information regarding health coverage options; does not sell insurance, receive compensation from insurers, or provide legal or tax advice.
• Enter and maintain consumer information in Washington Healthplanfinder in compliance with Exchange security, confidentiality, and access standards, including periodic required logins to maintain account access.

QUALIFICATIONS AND REQUIREMENTS

Education:

• High school diploma or equivalent required;
• Associate’s or Bachelor’s degree in health administration, social work, or related field preferred.
• Must complete initial Navigator certification training through the Washington Health Benefit Exchange (WAHBE) Learning Management System (LMS) prior to providing enrollment assistance.
• Must successfully complete all required annual and quarterly recertification trainings to maintain active Navigator status and system access.
• Must comply with WAHBE training timelines; failure to complete required trainings may result in suspension of Healthplanfinder access and inability to perform essential job functions.
• Must remain in good standing with the organization’s designated Navigator Lead Organization and follow all Exchange policies regarding privacy, impartiality, and consumer assistance.

Experience:

• Experience in health insurance, case management, or healthcare navigation preferred.
• Strong knowledge of Medicaid, Medicare, and ACA Marketplace programs.
• Excellent communication, interpersonal, and problem-solving skills.
• Ability to work independently and as part of a team.
• Proficient in Microsoft Office Suite and database management.
• Bilingual skills a plus

Licenses/Certificates/Registration:

• Valid drivers license and insurance

WORKING CONDITIONS

1. Comprehension
2. Ability to understand, remember, and apply oral and written instructions or other information.
3. Reasoning and Decision Making
4. Ability to plan, organize, and carry out assignments from management staff with minimal direction.
5. Ability to analyze situations and make decisions that moderately impact the immediate work unit.
6. Organization
7. Ability to organize and prioritize job duties effectively and timely, set priorities, and meet critical deadlines.
8. Communication
9. Ability to understand and follow basic instructions and guidelines, complete routine forms, and communicate orally.
10. Physical requirements for this position include hearing, seeing, smelling, speaking, feeling, reaching, pinching, and repetitive motions.
11. This position requires standing, walking, and bending for long periods.
12. This position may require exerting up to 40 pounds of force to lift, carry, pull, or move objects.

Benefits:

We offer a comprehensive benefits package (full time employees) including:

• Medical, dental, vision, life, and supplemental insurance
• Health savings, flex spending, and dependent care accounts
• 401K with employer matching
• Generous PTO and holiday pay

For additional information on benefits:

- content/uploads/2025/12/EE -Benefit-Summary-12.10.25.pdf

Triumph Treatment Services complies with federal and state laws and applicable discrimination regulations based on any protected class as defined by law. Triumph Treatment Services specifically does not discriminate on the basis of sex, race, creed, religion, color, national origin, age, honorably discharged veteran or military status, sexual orientation including gender expression or identity, non-job related sensory, mental or physical disability, or the use of a trained guide dog or service animal by a person with a disability. This holds for all employment opportunities at Triumph Treatment Services.