JOB STATEMENT

The Navigator II is responsible for assisting patients with the clinic registration process and the enrollment to different local, state, and federal health coverage programs.  This role requires a deeper understanding of community resources and the ability to handle a higher volume of clients with diverse needs.

JOB FUNCTIONS

• Assists individuals enrolling in clinic sliding fee, Medicaid, CHIP, Marketplace/ACA health plans, or other qualified programs.
• Provides patients with information about insurance affordability programs and coverage options.
• Educates patients about insurance including deductibles, co-insurance, and premiums.
• Interviews benefit recipients at specified intervals to certify their eligibility for continuing benefits.
• Interprets eligibility requirements, application details, and legal rights.
• Compiles records and evaluates personal and financial data.
• Troubleshoots and helps resolve more complex customer complaints or concerns.
• Works with team members to identify system and workflow improvements to enhance efficiencies.
• Keeps records of assigned cases and prepares reports.
• Build and maintain strong relationships with community partners and represent the organization at community events.
• Participates in quality and performance improvement activities.
• Serve as a mentor or resource to Navigator I staff.
• Performs other tasks as required by supervision.

JOB QUALIFICATIONS

• Education:
  • High School Diploma or equivalent
• Specialized Training/Certifications/Licenses:
  • Certified Application Counselor (ACA) Certification preferred
  • Federally Facilitated Marketplace (FFM) Assister Training preferred
  • Community Partner Program (CPP) Training preferred
• Experience:
  • 4 yrs. Eligibility Experience; or
  • 2 yrs. Eligibility Experience + Associate's Degree
  • 0 yrs. Eligibility Experience + Bachelor's Degree
• Knowledge:
  • Health insurance regulations and enrollment procedures preferred.
• Skills:
  • Computer Literacy
  • Microsoft Office (Word, Excel)
  • Customer Oriented
  • Confidentiality
  • Effective Communication
  • Fluent in English, Spanish is a plus.
• Abilities:
  • Must be able to speak, read, write, and comprehend the English language.
  • Ability to sit for majority of the shift.
  • Must be able to bend or stoop.
  • Must be able to lift 20 lbs. unassisted.
  • Must have good vision (e.g. near acuity and depth perception)
• Other:
  • Must be able to periodically work on Saturdays.
  • May require some local travel between different clinic locations.
  • Must be able to maintain required immunizations as required by the organization.
  • Must be able to obtain/maintain required certifications within 90 days of hire (training will be provided).
  • Must be able to pass Texas Health Department background to assist with state program applications.