Health Insurance Enrollment Specialist (Healthcare Customer Service)

Job Title

Job Description Required Education: Bachelor's degree in health administration, Public Health, Healthcare Management, or a closely related field. Preferred Education: Master's degree in health administration, Public Health, Healthcare Management, or a closely related field.

Required Qualifications/Experience/Skills:

• Minimum of four (4) years of front-facing customer service experience, preferably in a healthcare, public health, health insurance, or health administration setting
• Experience working in a health administration environment with demonstrated knowledge of healthcare operations, processes, and client service delivery
• Proven ability to thoroughly document client interactions, research issues, conduct appropriate follow-up, and bring issues to resolution in a timely manner
• Strong problem-solving skills with the ability to analyze complex situations, identify solutions, and coordinate resolution among multiple priorities while maintaining a high level of accuracy and attention to detail
• Ability to work effectively in a moderately-paced environment while managing multiple tasks and maintaining a high level of accuracy and attention to detail
• Demonstrated ability to adapt quickly to changing procedures, priorities, and program requirements
• Excellent verbal and written communication skills, with the ability to communicate professionally with case managers, healthcare professionals, Client staff, vendors, and community partners
• Strong organizational and time-management skills
• Proficiency in Microsoft Office applications and experience working with databases, case management systems, or other electronic information systems simultaneously
• Ability to maintain confidentiality and comply with all applicable HIPAA, Client Program, and organizational requirements

Preferred Qualifications:

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

Overview:

This position provides real-time technical assistance and customer support related to IAP enrollment and participation, while helping identify trends, resolve complex cases, and promote consistency across statewide program operations.

Key Responsibilities:

• Program Support and Enrollment Assistance:
• Serve as the primary point of contact for Client case managers seeking real-time assistance with Insurance Assistance Program (IAP) enrollment, eligibility, renewals, and participation
• Guide program policies, procedures, documentation requirements, and enrollment processes
• Assist with troubleshooting enrollment barriers and resolving issues that may impact clients' access to insurance coverage and HIV medications
• Ensure accurate and timely communication regarding program updates, enrollment requirements, and procedural changes
• Client and Case Management Support:
• Collaborate with medical case managers throughout Tennessee to identify and resolve ADAP issues affecting HIV/AIDS clients
• Support efforts to remove barriers to care and medication access for eligible clients
• Research and resolve client-specific concerns while ensuring compliance with program guidelines and confidentiality requirements
• Promote a client-centered approach focused on continuity of care and access to treatment
• Partner Collaboration and Issue Resolution:
• Work closely with Client partners, vendors, and managers to resolve complex operational and client-related issues
• Escalate and coordinate resolution of cases requiring multi-agency or cross-functional involvement
• Assist in identifying systematic issues, recurring challenges, and emerging trends affecting program operations or client outcomes
• Provide feedback and recommendations for process improvements that enhance program efficiency and effectiveness
• Communication and Customer Service:
• Manage a high volume of incoming and outgoing telephone calls and electronic communications
• Maintain efficient, streamlined, and uniform communication with field case managers, Client staff, healthcare providers, and program partners
• Provide professional, responsive, and solution-focused customer service
• Document interactions, resolutions, and follow-up activities in accordance with established procedures
• Operational Excellence and Quality Improvement:
• Monitor workflows and support efforts to maintain operational excellence across the ADAP program
• Assist with quality assurance activities, data validation, and program monitoring initiatives
• Identify opportunities to improve processes, communication, and service delivery
• Participate in meetings, training, and collaborative workgroups to support program goals and continuous improvement efforts

**Only those lawfully authorized to work in the designated country associated with the position will be considered.**

**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**