Health Insurance Specialist

RIPIN

Job Posting

Call Center Specialist

Salary Range: $20-$22/hour

About RIPIN:

RIPIN deploys a peer model to support people with special healthcare and education needs across the whole lifespan. Founded in 1991 by a group of parents of children with special needs, RIPIN continues to be peer-led: a majority of our board and more than three-fourths of our staff are parents or caretakers of loved ones with special needs. RIPIN's peer professionals now help more than 45,000 Rhode Islanders every year navigate healthcare, schools, and other support systems.

Job Summary:

The Consumer Resource Specialist will provide comprehensive phone support to consumers navigating health coverage as it relates to the state/federal insurance regulations. The Consumer Resource Specialist also serves as an intermediary and first point of contact, connecting consumers to RIPIN programs that support a range of services across the lifespan, including special education, care coordination, and healthy aging. The Consumer Resource Specialist will ensure all individuals are supported in a responsive and timely manner with a primary focus of providing consumers and their families with information, resources, guidance, and assistance using a peer-to-peer support model.

Essential Functions:

• Provide daily telephone support to consumers regarding health matters, offering information, resources, support, and problem-solving to assist consumers in accessing, and /or obtaining health benefits. Provide wraparound case management and advocacy to consumers with complex needs
• Assist consumers in understanding and accessing the appeals process in health insurance. Document any grievances: assist in the coordination and submission of grievances as required by funding sources and/or other public and private agencies. Refer consumers to other services or public or private agencies for additional supports as needed
• Connect consumers with appropriate RIPIN programs and services, including those that address special education, care coordination, and healthy aging. Facilitate seamless transitions between programs to ensure comprehensive support for consumers across the lifespan.
• Collaborate with RIPIN staff to continuously develop, assess, and implement outreach plan for call center programs to ensure seamless service delivery and to avoid duplication of services. Continuously develop, assess, and implement program awareness campaign to generate consumer utilization of call center resources
• Accept other duties and responsibilities as assigned

Knowledge, Skills and Abilities:

• Advanced knowledge of health systems in RI and other human service systems supporting consumers in obtaining, maintaining, and accessing public and commercial health insurance programs
• High level of interpersonal skills and excellent communication skills to interact on a professional level with our diverse stakeholders, including consumers and professionals
• Ability to convey complex information in a clear and understandable manner
• Fluency (speaking, reading, and writing) in English and Spanish desired

Education and Experience:

• High school diploma/GED required, Associates Degree or bachelor's degree in Human Services, Education, or related field strongly preferred
• Personal experience navigating healthcare for self or family member highly desired
• Experience working with and outreaching to diverse populations

Physical Demands:

• Regularly required to talk or hear
• Regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms
• Regularly required to climb stairs, reach, stretch, stand and bend
• Required to have the ability to lift and/or moves up to 25 pounds
• Required to remain at their station for prolonged periods of time

Working Conditions/ Work Environment:

• Primary work location is a climate-controlled indoor office environment; however, may also be required to conduct visits in private homes, climbing up to three flights of stairs, and community locations
• Flexibility for travel related to job requirements
• Willingness and ability to work evenings and weekends as needed
• Provide own reliable transportation with proof of valid driver's license and RI requirements of auto insurance

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

RIPIN provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, or status as a covered veteran in accordance with applicable federal, state, and local laws.