Insurance specialist

Best Place to Work in Northern Nevada - 1st Place Winner 2024

Best Place to Work for Working Parents - 2024

Check out our AWESOME Benefits!

• 4 weeks Paid Time Off in the First Year - Front Loaded
• 14 paid holidays annually
• Hybrid Work Options Available
• 403B Retirement Plan with 4% Match
• 4 Weeks Paid Parental Leave
• Up to 4 Weeks Paid Catastrophic Leave
• Medical, Dental, and Vision benefits - effective 1st day of the month, following date of hire
• Free Health Insurance Options for Full Time Employees
• Low-Cost Health Insurance Options for Dependents
• Health Reimbursement Account
• Employee Hardship Loan Program
• Free Life Insurance and Long-Term Disability
• Tuition Assistance
• Continuing Education Support
• Dog Friendly Workplace
• Child Friendly Workplace
• Great Organizational Culture!

JOB PURPOSE : The Ryan White Health Insurance Specialist is responsible for maintaining the highest professional and ethical standards in representing Access to Health Network (AHN) to Ryan White clients and business partners.

The ideal candidate is a motivated, hard-working, organized individual who performs well under pressure and can multi-task.

This position is responsible for assisting Ryan White clients with enrolling into an insurance product as well as processing premiums and processing Nevada Medication Assistance Program (NMAP) referrals from partner agencies.

BASIC REQUIREMENTS :

• Bilingual (English / Spanish) mandatory.
• Required to pass a background check through the State of Nevada.
• Abide by all HIPAA requirements.
• Must have a valid driver's license and be able to drive the AHN company car when needed.
• Must be able to obtain an Exchange Enrollment Facilitator License (EEF) within 90 days at the agency's expense.
• Gain and maintain a general working knowledge of health insurance systems and terminology.
• Gain a clear and basic knowledge of Access to Healthcare Network administrative duties, services, and systems.
• Must attend staff meetings and be willing to meet with direct reports.

KEY RESPONSIBILITIES AND ACCOUNTABILITIES :

• Have a working knowledge of non-AHN health care programs such as Medicaid, Medicare, Nevada Check-Up, Prescription Drug Programs and Women's Health Connection.
• Ability to be both compassionate and professional while serving the program population.
• Always treat AHN clients and prospective clients with respect and dignity.
• Fulfill parts of the Scope of Work for the Nevada Department of Health and Clark County Nevada.
• Eligibility screening for potential Ryan White services to ensure clients are eligible for assistance.
• Process referrals in accordance with AHN policies and procedures.
• Gain a general working knowledge of Nevada / Federal Health Exchange, HIP, Access to Healthcare Network, State Health Insurance Subsidies / Assistance Program, and Medicaid including the eligibility criteria and enrollment process.
• Help eligible consumers enroll in Premium Assistance Program which is also known as 3rd Party Reimbursement.
• Process premium payments on behalf of consumers for state-approved insurance plans.
• Ensure that the Ryan White Part B files are up to date with the necessary documents.
• Gain a mastery of Access to Healthcare Network services available to our members.
• Submit all programmatic reports on time, in a professional format and with accurate data.
• Process NMAP referrals from partner agencies to determine payer source and grant NMAP eligibility.
• Gather information from AHN Ryan White clients to determine the payer of last resort.
• Develop and maintain effective working relationships with AHN providers, members, program partners and program funders.
• Accurately and efficiently record all pertinent client information into CareWare and Salesforce
• Ensure that database and spreadsheet entries are updated regularly, and new information is input as it becomes available.
• Be able to multitask and critically think though a variety of situations.
• Gain a basic and clear working knowledge of Salesforce and CAREWare.
• Perform detailed, accurate review of all applications that may qualify for insurance.
• Ability to describe and communicate complex concepts.
• Flexibility; Ability to adapt to changing work environment and duties. Each department selects the hours of work schedule for the department staff based on the department's needs.

This schedule may change at any time according to the department's needs.

Other duties as assigned.

EDUCATION MINIMUM :

High School Diploma; AA Degree Preferred.

EXPERIENCE MINIMUM :

• One year minimum in health insurance, sales, and health insurance specialist experience preferred.
• Demonstrated experience in planning and execution of organizational communication.

WORK ENVIRONMENT :

• The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office environment.
• Be able to sit at a computer for 6 - 8 hours per day.
• Be able to stand between 3 - 6 hours per day.
• Be able to withstand hand / wrist deviation and repetition.
• Must be able to lift, carry up to 30 pounds with a fair consistency.

The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified.

As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network.

Furthermore, they do not establish a contract or implied contract for employment.

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds.

We encourage all qualified candidates to apply.

Last updated : 2024-08-27

Salary : $24