Lead Patient Benefits Navigator at ESPERANZA HEALTH CENTERS

Esperanza Health Centers offers benefits to all its full-time employees:

BCBS Medical PPO Plans| Ameritas Dental |Eye Med Vision| Tuition Reimbursement up to $5,000 per year|10 Paid Holidays and 16 Days of Paid Time Off

Compensation (Based on experience and qualifications): $21-26 per hour

The Lead Patient Benefits Navigator reports to the Patient Benefits Navigator Manager. Responsibilities include, but are not limited to, assisting patients with enrollment in Medicaid, Medicare, or Marketplace insurance coverage, facilitating patient empanelment, providing patient and staff education on healthcare benefits, and linking patients to medical home resources within Esperanza.

The Lead Patient Benefits Navigator will serve as a resource for the team, providing guidance and troubleshooting problems

Primary Duties and Responsibilities: (The following duties and responsibilities are all essential job functions except for those that begin with the word “May.”)

1. Provide enrollment assistance (including, but not limited to, completing applications, gathering required documentation, and following up with state and federal enrollment agencies) for uninsured and underinsured patients.

2. Provide patient education on health coverage, assist in benefit navigation, and offer renewal/redetermination assistance for enrolled individuals.

3. Assist in plan selection for HealthChoice Illinois (Medicaid) and Medicare Advantage beneficiaries.

4. Review monthly payer redetermination reports and proactively perform outreach to facilitate redetermination and prevent loss of benefits.

5. Assist pregnant patients with Medicaid Presumptive Eligibility (MPE) and Moms & Babies enrollment.

6.Pointcare: Review Submitted applications for any errors or inconsistencies. Review follow up’s on submitted applications are done in a timely manner according to organizations policy. Review Error verify job reports and maintain at a low level.

7. Managing “Patientbenefits” Bucket daily, making sure team is reaching out in a timely manner according to organizations policy.

• High School Diploma or equivalent, required
• Bachelor's Degree or relevant experience, preferred
• Previous knowledge of Medicare, Medicaid, and Marketplace benefit coverage
• Excellent verbal and written communications skills
• Bilingual English/Spanish, required