State Programs Facilitated Enroller

About the position

The State Programs Facilitated Enroller is a vital role within CDPHP, responsible for assisting individuals with enrollment and renewal applications through the NY State of Health marketplace system. This position requires a thorough understanding of the enrollment process, including the review of taxes, payroll stubs, and other income documents to determine eligibility according to the guidelines set forth by the New York State Department of Health (NYSDOH). The Facilitated Enroller will conduct outreach and enrollment calls, working directly with customers over the phone to assist them in renewing their applications or completing new applications as permitted by the state. This role also involves answering inquiries regarding specific CDPHP plans offered through the NY State of Health, processing member recertification applications, and managing adds, changes, and terminations of member accounts. In addition to the core responsibilities, the Facilitated Enroller is expected to handle renewals over the phone and participate in community outreach events as needed. All enrollers must adhere to the regulations and instructions set forth by both the state and federal government, ensuring compliance with all defined CDPHP standards of outreach. The position requires a proactive approach to problem-solving, excellent customer service skills, and the ability to maintain confidentiality while managing sensitive information. The ideal candidate will thrive in a fast-paced environment and possess strong analytical skills to effectively research and resolve issues as they arise.

Responsibilities
• Assist individuals with enrollment and renewal applications through the NY State of Health marketplace system.
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• Review taxes, payroll stubs, and other income documents to determine eligibility according to NYSDOH guidelines.
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• Conduct outreach and enrollment calls to assist customers with renewing or completing new applications.
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• Answer questions regarding specific CDPHP plans offered through NY State of Health.
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• Process member recertification applications, adds, changes, and terminations.
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• Handle renewals over the phone and participate in community outreach events as needed.
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• Ensure compliance with regulations and instructions set forth by NYS and the Federal government.
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• Meet all defined CDPHP standards of outreach.

Requirements
• Marketplace Facilitated Enroller certification or Certified Application Counselor certification required, or must be obtained within 30 days of hire.
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• Minimum of 1 year employment experience in a health insurance setting required, with experience in Government Programs preferred.
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• High school diploma or GED required.
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• Demonstrated ability to interpret and make decisions based on corporate underwriting guidelines, as well as State of New York & Federal statutes relating to healthcare administration.
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• Demonstrated ability to pro-actively identify problems and recommend and/or implement effective solutions.
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• Demonstrated ability to work with and maintain confidential information.
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• Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
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• Excellent verbal and written communication skills.
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• Flexibility to adapt to a changing and fast-paced environment.
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• Strong system research and analysis skills; deductive and creative thinking.
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• Strong attention to detail and capability to meet established productivity and quality standards.
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• Demonstrated ability to effectively manage time with multiple task assignments.
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• Access to reliable internet for work from home is required.

Nice-to-haves
• Ability to speak Spanish or another language preferable.

Benefits
• Award-winning health care coverage
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• Health care dollars
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• Generous paid time off allowance
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• Employee assistance programs
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• Flexible work environment
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• Incentive payment based on performance
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• Potential for overtime pay

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