ENROLLMENT SPECIALIST

Description

SIHB Core Competencies

Core Competencies are foundational commitments and skills that all SIHB staff are expected to develop. These competencies define common measures for performance that are applied to every role in the organization.

• Commitment to Indigenous and Organizational Values: Everything we do at SIHB is centered on Traditional Indian Medicine. It is our responsibility to maintain cultural integrity in all that we do.
• Accountability: All employees of SIHB effectively manage their own work and the work of their teams. We take ownership of our actions and decisions. We all strive to deliver the highest quality work and care, while respecting our teammates and Patients.
• Collaboration: SIHB is a team-oriented organization. As team members, we share the responsibility of working toward a common purpose. We collaborate with our colleagues across the organization to deliver the highest quality of care and results in alignment with our mission, vision, values and Theory of Change.
• Communication: We practice effective and clear communication with staff, Patients, teams and community. We demonstrate empathy among each other and with those we serve, and transparency in our decision making.
• Customer Service Orientation: All employees of SIHB recognize the needs of the diverse community we serve. We put the needs of our Patients first by delivering the highest quality, professional, responsive, and innovative care. Our Patients come first and deserve the best.

Position Summary:

Seattle Indian Health Board (SIHB) has an outstanding opportunity for an Enrollment Specialist. The Enrollment Specialist position supports SIHB efforts to attract new patients and enroll uninsured patients with health insurance. Primary duties include enrolling new patients for services and insurance; and responding to requests for information, application assistance and follow-up. Verify and record patient demographic and income information for sliding fee scale placement if appropriate.

Organizational Structure/Reporting Relationships:

This position reports directly to the Director of Operations and is a member of the Operations team. This position has no direct reports.

Organizational Responsibilities

• Hold Indigenous values and practices with respect and integrity
• Hold yourself accountable to the highest standard by being resourceful, innovative, creative and solutions-oriented
• Actively participate in organizational activities with the understanding that success is achieved through teamwork.
• Recognize that communication is central to the organization's success and actively champion your words and actions to maintain respect for others, encourage constructive feedback, be open to share laughter and acknowledge differences in skills and opinions, all while keeping others' best intentions in mind.
• At SIHB, we refer to our customers as Relatives. Our Relatives come first and deserve the best. Serve the needs of our Patients first by delivering the highest quality, professional, responsive and innovative care.

Requirements

Job Responsibilities, Qualifications and Education

Responsibilities:

• Conduct in-depth interviews with patients to determine eligibility for services, insurance and financial assistance discount programs.
• Interpret rules and regulations of insurance, offering fair, accurate and impartial options while explaining the rights and responsibilities of patients
• Assist in completing enrollment applications, gather required documentation, verify pertinent eligibility information. i.e., proof of patient's AI/AN identity as described in SIHB's Policies, family information, income, financial resources.
• Serve as a patient representative helping to access health insurance programs through the health insurance marketplace (Washington HealthPlan Finder), Washington Apple Health, Medicare, Medicaid, and resolving issues that may arise during the enrollment process.
• Assist and educate patients as insurance options come available, identifying the affordable coverage that best meets their needs and help with annual renewal and open enrollment process.
• Assist patients with completing and processing applications for financial assistance discount programs.
• Check insurance eligibility and scan Medicaid, Medicare, and private insurance cards.
• Assist patients with payments and answer questions regarding accounts/statements
• Verify and update patient demographics, insurance coverage, health histories, and Patient Notice of Privacy Practices
• Attend and successfully complete all required training programs; participate in ongoing conference calls, webinars and other professional development opportunities.
• Practice's confidentiality and privacy protocols in accordance with clinical policies and HIPAA requirements.
• Proactively identify resources, strategies, and initiatives to increase effectiveness of desired outcomes of patient insurance enrollment.
• Receive patient complaints, document, and respond in a professional and confidential manner.
• Provide back-up coverage for Navigator and/or Community Relations Advocate as needed.
• Actively participate in internal quality improvement teams and work with members proactively to drive quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards, when assigned.
• Other job-related duties as assigned

Qualifications:

• Candidate must possess strong critical thinking and problem solving skills.
• Familiarity working with diverse communities including American Indian/Alaska Native (AI/AN) population and a desire to serve our population.
• Experience or familiarity with the roles and responsibilities of a Tribal Assister specific to AI/AN patients.
• Experience with practice management or other scheduling and registration software required.
• Experience with insurance market, including government insurance and private insurance; ability to simplify and effectively explain how insurance works.
• Demonstrated ability to navigate complex insurance choices and guide patients to options that best suit their needs, weighing financial outlay, spend considerations and long-term savings goals.
• Exceptional interpersonal skills with the ability to develop relationships with patients and cross functional teams providing a positive experience.
• Able to work independently as well as within a team environment.
• Deep knowledge of Apple Health, Medicare, Medicaid, insurance resources.
• Always provide exemplary customer service
• Strong organizational skills and attention to detail.
• Demonstrate proficiency with computer-based applications such as MS Office, Adobe, spreadsheets, email and other computer software programs.

Education:

• Bachelor's Degree with human service-related focus or an equivalent four years' experience in health benefits or healthcare financial eligibility screening required.
• WA Affordable Care Act Navigator certification.

Work Environment:

Normal office environment. Most work involves sitting, standing, working at a computer, processing paperwork, scheduling appointments via phone and fax machine. Consistent interpersonal engagement with patients and staff. Office hours are 8-5, Monday through Friday with occasional extra hours for events or to meet deadlines.

FOR INFORMATION ABOUT OUR BENEFITS PACKAGE, PLEASE VISIT OUR WEBSITE AT: