Benefit & Advocacy Specialist

ChasmTeam is partnering with a growing national company, to build a team that provides real benefits to patients! We are seeking hard working, self-starters who enjoy a challenge as we work together to help patients. The Benefit & Advocacy Specialists are responsible for enrolling HIPP eligible Medicaid patients and other qualified family members onto employer sponsored health insurance. The enrollment process will require direct contact with employers, policy holders, third party administrators, employee benefit portals, insurance brokers and in some instances legal counsel.

The job duties as outlined below will require someone with strong attention to detail, critical thinking and organization as well as written and verbal communication skills. Perseverance, resilience, determination, adaptability, and teamwork with all departments is required to excel in this role.

Job responsibilities and duties

1. Employer Enrollment

· Communicate with all parties involved via email, text, and phone calls

· Understand and evaluate employment laws, insurance plans and state subsidy programs to educate all parties involved

· Research employers via employer database, past cases, collaboratively with the BAS team and using online resources available.

· Obtain and/or review benefit guides, summary plan descriptions, plans, rate sheets and summary of benefits

· Analyze cases for benefit eligibility, employer requirements and strategize applicable enrollment options

· Anticipate potential problems and develop solutions before they occur

· Work with benefit specialists and employees to assist with phone and online enrollments

· Respond and accurately document all inquiries from employers, brokers, legal counsel, and employees

· Work closely with the employer to problem solve and assist with calculating retroactive premiums and payment options to ensure retroactive premiums are paid

· Obtain any state required documentation from the employer as needed

· Expedite the verification process by obtaining temp IDs

· Post enrollment, review information obtained to confirm all commercial enrollment information is accurate and documented

· Work with employers to assure coverage is either secure or obtain options available during any type of leave of absence

· Guide employers, brokers, and work with families to rectify any employer sponsored insurance discrepancies

· Assist families with any coverage issues that may arise from termination of employment and obtain COBRA paperwork if applicable.

· Work may require proactive, policy holder advocacy initiatives to ensure patient and employee rights are respected

2. Assist Patient/Families Enroll

· Review the entire case to understand the needs of the family

· Assist employees with understanding election options and requirements by working closely with their employer and/or benefit administrator throughout the entire enrollment process

· Review paystubs to ensure the correct plan and rates are being deducted from the employee and that States reimburse accordingly

· Work with the employee and employer to develop solutions for any discrepancies discovered in the payments and/or repayment letters

· Empower employees by educating them about their benefits

3. Other (meetings, training, etc)

· Attend case review calls each week

· Attend Commercial Enrollment department meetings and trainings

· Collaborate cross departmentally with all teams as needed

· Perform other duties as needed & assigned

Skills and abilities needed for this position:

· Excellent written and verbal communication and people skills via phone, video and email to effectively educate and gather pertinent information

· Proven problem-solving and conflict resolutions skills while showing patience and empathy

· Research, analytical and critical thinking skills

· Ability to work independently (yet ask for help when needed). Teamwork is essential.

· Outstanding time management to prioritize, organizational skills and attention to details to ensure accuracy

· Demonstrate ability to explain complex topics/processes in simple layman’s terms for employers and patients to understand

· Exhibit adaptability, initiative and strategic thinking to have a broader business view

· Insurance background helpful

· Knowledge of employee benefits and employment laws

· Technically savvy

· Ability to work in a fast-paced position in a high growth organization