Patient Service Representative III- Medicaid Navigator
: Job Details :

> Position: Patient Service Representative III- Medicaid Navigator Location: Minnie Jones Health Center 257 Biltmore Avenue Asheville, NC Job Id: 491 # of Openings: 1PATIENT SERVICES REPRESENTATIVE III (PSR III)- Medicare NavigatorAre you passionate about the patient experience?Western North Carolina Community Health Services (WNCCHS) is a Federally Qualified Health Center (FQHC). We are looking for a friendly and welcoming individual who enjoys patient interaction for a full-time role as Patient Services Representative III (PSR III)- Medicaid Navigator.The Patient Service Representative III is a certified application counselor who provides outreach, education and information to patients and the public about various options for enrolling in North Carolina Medicaid and Qualified Health Plans (QHP) available through the Health Insurance Marketplace of the Affordable Care Act and assists patients in the preparation and submission of the application.RESPONSIBILITIES- Includes but not limited to the following:* Demonstrates competency in performing the position responsibilities of the Patient Access Specialist I and II roles when needed. This includes being proficient in patient registration, check-in/out, co-pay collections, eligibility determination, and all front desk workflows.* Successfully completes the North Carolina Certified Application Counselor exam; complies with all continuing education and recertification requirements.* Conducts and participates in outreach activities aimed at engaging patients and encouraging health insurance application.* Provides information to patients and the public about North Carolina Medicaid programs and the full range of options for which they are eligible.* Helps patients achieve and maintain enrollment in North Carolina Medicaid completing paper and internet-based application forms, helping the patients gather the necessary documents, and following the process through final outcome.* Helps patients resolve administrative problems with health care payers, (i.e., helping a patient request a lost Medicare card, complete a PCP change form, or work with the payers to change beneficiary provider assignment).* Clarifies distinctions among health coverage options and helps consumers make informed decisions about health coverage.* Assists consumers in submitting Marketplace and Medicaid eligibility applications using the federal exchange website or the NC E-Pass portal.* Supports patients through enrollment, appeals, and annual redetermination processes.* Agrees to serve consumers' best interests.* Complies with privacy and security standards.* Provides professional and confidential assistance to all patients seeking health benefits.* Participates in mandatory in-services, drills, staff meetings and other trainings.* Performs duties in a prioritized, organized, and orderly manner to maximize efficiency and productivity.* Facilitates the maintenance of a clean, neat and well-organized work area.* Participates in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and/or controlling program goals, objectives and/or services.* Supports current incentive, regulatory, and certification requirements (such as PCMH and UDS) through documentation, participation in initiatives, and other activities as directed.* Performs other duties as assigned.QUALIFICATIONS* At least one year in a customer-facing role in any service-related industry.* Knowledge of federal poverty level as applied to sliding fee scales.* Sliding fee scale experience required.* High School diploma or equivalent required.* At least one year in a medical office setting is preferred.* Bilingual English/Spanish, or English/Russian, is highly desired.ADDITIONAL SKILLS REQUIRED1. Successfully achieve the Certified Application Counselor certification by passing the required examination.2. Complete all NC Medicaid and CMS-approved training regarding QHP options, Insurance Affordability Programs, Medicaid, eligibility, and benefits rules and regulations governing all Insurance Affordability Programs operated in the state, as implemented in the state.3. Complete and achieve a passing score on all CMS-approved training examinations4. Outstanding customer service skills with the ability to give accurate/tactful explanations to visitors, patients and co-workers and remain calm and professional under stressful situations.5. Ability to read, comprehend and apply standard operating procedures.6. Ability to effectively present information by telephone and in one-on-one situations to patients and to staff.7. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers.8. Ability to apply common sense understanding to carry out written or oral instructions.9. Advanced knowledge of insurance plans gained through experience or education.10. Ability to accurately enter information into EMR database required.11. Basic computer literacy and clear writing skills are essential.12. Effective telephone skills needed to receive/relay and place telephone calls continually throughout the day.13. Ability to articulate information clearly with unhampered conversational skills for communication with a multicultural/multiethnic/multilingual patient community.14. Ability to listen and understand information, direction and ideas presented in spoken words and sentences.15. Excellent attention to detail and accuracy in working on assignments and tasks.WORK/LIFE BENEFITS* Competitive health plans for employees and dependents including Medical, Dental, Vision, and Telehealth* Ten (10) Paid Holidays* Two (2) Floating Holidays* Accrued PTO (total of 156 hours 1st year)* No weekends or holiday work required* Employee Assistance NetworkFINANCIAL WELL-BEING BENEFITS* 403b Retirement Savings with Match* Employer Paid Short/Long Term Disability Insurance and Life Insurance* HRSA and Public Non-Profit Student Loan ForgivenessCAREER GROWTH BENEFITS* Monthly Staff Meetings and Training* Relias Learning Management System* Continued Medical Education (CME) & Continuing Education (CEU)* Leadership AcademySupportive of Diversity, Equity, and Inclusion.Western North Carolina Community Health Services is an equal opportunity employer, and all qualified applicants will receive consideration for employment, services, programs or activities without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.Hourly range $19.50 to $21.00.