Member Financial Counselor

Member Financial CounselorJob Summary:The Member Financial Counselor will directly support ArchWell Health members with signing up for state and federal assistance programs to aid members in optimizing benefits they are eligible to receive in addition to providing support for member finance inquiries for ArchWell Health and non-ArchWell Health medical bills. This role will require technological proficiency and the ability to competently navigate the requirements of the health plans state and federal assistance programs. This role will have a significant data input component to ensure success of the program is captured and understood across Centers and Markets. This is a professional role where ongoing feedback will be provided and working closely with the Member Financial Counseling leadership is a requirement. Duties/Responsibilities:Connect with members over the phone to assist in completing paperwork for eligibility determination enrollment and recertification of state and federal programs; including but not limited to Medicaid D-SNP Medicaid and Medicare Savings Program (MSP) Low-Income Subsidy (LIS) Supplemental Nutrition AssistanceProgram(SNAP) and Low Income Home Energy Assistance Program (LIHEAP)Provide member support in a contact center environment meeting established productivity quality service and compliance standards while delivering effective solutions that achieve desired member outcomes support financial well-being and enhance the overall member inbound and outbound calls with members to provider education resolve benefit-related concerns and identify opportunities for enhanced coverageProactively identify members who are eligible for the programs available to reduce member financial responsibilityReceiving inbound calls from members during established coverage windowsEvaluate research and document financial histories of patients in relation to Medicaid and other state/federal program data into various internal and external systems (financial management system Medical Eligibility Program database etc.). Inputs necessary data to assist in the necessary capture for physicians nurses social workers employers banks etc. to obtain appropriate medical legal and financial information to complete Medicaid. Support ArchWell Health Cost Share Assistance ProgramExercise and maintain patient confidentiality by complying with all federal state and local statues or other agency regulations pertaining to confidentiality and patients right to related duties as directed by financial program leader. Required Skills/Abilities:Strong working knowledge of Medicaid SNP and assistance programs financial counseling practices eligibility requirements and procedures for multi-state and federal programsStrong understanding of state and federal assistance programs including Medicaid and managed care plan enrollment and participation requirements with multi-state Medicaid experience preferredExcellent verbal communication and active listening skills with the ability to conduct effective member conversations assess needs provide education and guidance and influence positive member outcomesAbility to partner and communicate with stakeholders in a professional manner Strong organization and written communication skillsExcellent problem-solving skillsProven performance results decision making and judgementStrong PC skills with ability to navigate state benefit portals and eligibility systems. Must understand medical insurance to be able to discuss and explain balances deductibles co-pays co-insurance. Ability to read and interpret an explanation of benefits (EOB). Ability to understand and present dataAbility to communicate well with all levels of staff providers patient referral sources and membersOccasional travel required (5-10%)Minimum Qualifications:Bachelors degree preferred or equivalent experience; H.S. diploma or equivalent requiredMinimum of 3 years experience related to Medicaid and other assistance program eligibility requiredAdvanced working knowledge of Medicaid Medicare Advantage and other state and federal benefits programs serving seniors including eligibility requirements enrollment processes benefit coordination and plan selection. Ability to independently guide members through benefits counseling and enrollment with multi-site healthcare delivery organizations desiredExperience with capitated risk-based reimbursement models strongly preferredProficient in Microsoft Word Excel PowerPoint Outlook Ability to learn and work with different software to perform duties of role including Salesforce Teams and eCW (eClinical Works)Embodies and serves as a role model of ArchWell Healths Values:Be compassionateStrive for excellenceEarn trustShow respectStay resilientAlways do the right thingAbout ArchWell Health:At ArchWell Health were creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship routine wellness and staying active our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard listened to and given ample time by their physicians to live well later in value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable accessible neighborhood centers where older adults can feel at home and become part of a vibrant wellness-focused community. Were passionate about caring for older adults and united by the belief that caring has the power to change everything for our Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race color religion age sex sexual orientation gender identity national origin disability veteran status or any other protected classification.