The Plan Based Enrollment Counselors help enroll new or existing members for renewal into the Covered California Program. The PBE’s educates customers on how the health care system is organized, what services are available to them and provides enrollment referrals or assistance to public or private health/social services. The PBE’s also serves as the Certified Application Assistor. The PBE’s transitions to ongoing administration of the terms in the agreements with Covered California and facilitates annual renewals.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Ability to understand and explain to customers how health care is delivered in the community.
- Provides strong customer service and support to potential clients
- Receive and handle inquiries by telephone, mail, and in person assistance for enrollment into the Covered California program
- Pre-screening and assist applicants for the program eligibility determination and enrollment
- Develop and maintain program policies and procedures for handling Covered California prospective, enrolled, and renewing customers.
- Compile and report information on customer feedback and program effectiveness
Produce regular reports and data submissions as required by Covered California and Healthy San Francisco programs
- Maintain and enhance relationship with Covered California and Healthy San Francisco programs
- Coordinate with other team members as needed to assist customers
- Provide language assistance to people with limited English proficiency to help in patient navigation (e.g. making doctor appointments, interpreting for physician offices, etc.)
- Accepts and performs other duties as assigned.
- Associate degree preferred
- Two years customer service or enrollment assistance experience; prior managed care experience preferred.
- Previously Certified as a Certified Application Assistor, desirable
- Results and detail oriented self-starter
- Must achieve and maintain HSF One-e-Application process certification
- Must Be Certified as an Enrollment Counselor Certification status within 2 weeks of hire
- Passionate about helping resolve customer health care system access issues
- Excellent oral communication, customer service and organizational skills
- Fluent and literate in English and Cantonese or Mandarin or Spanish desirable
- Able to lift up to 30 pounds
- Use proper body mechanics when handling equipment
- Standing, walking and moving 50% of the day.
Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.