Certified Application Counselor

About Vitra Health

Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs— supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.

To help share our mission and expand our community impact, Vitra Health is seeking a Certified Application Counselor who is passionate about community engagement and helping people access the care and resources they deserve.

The Opportunity

The Certified Application Counselor interviews, assesses, and screens patients to determine eligibility for qualified health plans and insurance affordability programs, including MassHealth/Medicaid. This role provides application assistance both in person and over the phone, ensures accurate and timely processing of applications in compliance with organizational policies, and collaborates with internal departments and external stakeholders to resolve patient financial concerns and coordinate benefits, particularly for patients with disabilities or complex coverage needs.

The Counselor educates patients and staff on Medicaid-related matters, supports open enrollment activities, and ensures appropriate financial counseling prior to scheduling non-covered or limited-coverage procedures. Additionally, this position promotes a culture of customer service and quality care, serves as a brand ambassador, mentors team members, and demonstrates a strong commitment to diversity and community engagement.

Key Responsibilities

• The Certified Application Counselor interviews, assesses and screens patients for eligibility for qualified health plans
• Assists over the phone and in person to address insurance coverage matters or concerns
• Provide application assistance to applicants and beneficiaries and insurance affordability programs including Masshealth and applicable health insurance programs
• Interviews, assesses and screens patients for eligibility for qualified health plans
• Responsible for tracking and processing accurate, complete and timely applications with regards to Virta's billing practices and procedures and consistent with the Certified Application Counselor Policy Requirements
• Works with departments to ensure resolution of patient financial concerns
• Helps coordinate services with outside stakeholders to provide necessary coverage for patients that require an enhanced coordination of benefits due to disabilities.
• Follows established protocols ensuring appropriate financial counseling actions have been taken and communicates back to the department prior to scheduling procedures that will not be covered by insurance. This includes elective, plastic, and/or low coverage or non-covered medically urgent procedures.
• Supports patients with MassHealth/Medicaid Open Enrollment, providing education and processing necessary applications.
• Addresses MassHealth and Managed Care concerns with patients who require assistance.
• Educate staff on matters related to Medicaid
• Foster culture of customer service and commitment to quality care.
• Serve as a brand ambassador for Vitra reflecting our vision, mission, and values.
• Show a genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members.
• Mentors and supports team members.
• Other duties as assigned.

What we are looking for:

• Certified application Counselor or must receive training and be certified as a Certified Application Counselor within 45 days of employment
• Must be able to travel to client home to support enrollment process
• Must be extremely organized, able to prioritize appropriately and make independent decisions, strong problem resolution skills
• Must be able to handle a heavy caseload of patients in an ongoing fashion and possess strong follow through skills
• Must demonstrate computer competency with use of keyboard and mouse and must demonstrate excellent customer service skills
• Must have a minimum of 2 years of experience with MassHealth rules and enrollment processes
• College degree preferred
• Must be extremely organized, able to prioritize appropriately, and make independent decisions, strong problem resolution skills.
• Must be able to handle a heavy caseload of patients in an ongoing fashion and possess strong follow-through skills.
• Must demonstrate computer competency with the use of keyboard and mouse and must demonstrate excellent customer service skills.
• Must be able to collaborate effectively across departments

Work Environment and Physical Requirements

• Office-based work in a clean well-lit environment with fluctuating temperatures near others.
• Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
• Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
• Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.

** Perks and Benefits: **

• Employer sponsored health Insurance with a generous employer match.
• Dental and Vision Benefits.
• Supplemental Benefits
  • Life, Accident, Critical Illness and Disability Insurance.
• 401K with a 5% company match.
• Accrued Paid-Time-Off.
• Ten company paid holidays.
• Wellness Benefits.
• Tuition Reimbursement.
• Supportive team structure and company culture with a focus on work/life balance.

Vitra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.