The Premium Assistance team collaborates with the Classic Program and the Outreach Enrollment and Access Program teams to help community members enroll in health insurance through the Oregon Health Plan or the Federal Marketplace. The Premium Assistance Program Coordinator supports the Program Manager and works closely with insurance carriers, as a third-party payer, for clients enrolled in the Premium Assistance Program. They are responsible for day-to-day operations of the program, such as: communicating with provider and hospital billing offices and advocating for and navigating insurance for clients.
The Program Coordinator works with the Program Manager to analyze and advise on strategic direction of the program, ensure compliance with HIPAA, cultural effectiveness, and language accessibility. This position requires a person who is flexible, self-directed, adept at change management who pays great attention to detail, communicates clearly and respectfully, is resourceful, highly analytical and a creative problem solver.
Principal Duties & Responsibilities
Work closely with Program Manager to oversee the financial and operational day-to-day program activities, ensuring adherence to program budget
Work with Program Manager to review, improve and implement workflows, implement strategic direction, program policies and procedures, troubleshoot problems, and ensure adherence to organizational and programmatic policies
Work effectively with external stakeholders including insurance carriers, community partners and volunteers to establish strong lines of communication and foster/maintain positive relationships to ensure continuity of funding and program services
Work internally with all teams to align programs, improve workflows, and support interconnectedness within the organization
Ensure compliance with HIPAA including management and maintenance of electronic files
Other duties as assigned
Program-Specific Duties & Responsibilities
Support the Program Manager in coordinating all aspects of the Premium Assistance Program.
Work closely with insurance carriers to ensure premium payments are made for all clients enrolled in Premium Assistance
Troubleshoot enrollment and payment issues by working closely with clients, insurance carriers, the Federal Marketplace, and state Medicaid agency as needed
Support the Program Manager to collect, analyze, and report data regarding finances, enrollments, and trends in the program
Coordinate activities of temporary program staff and be available to work extended hours during open enrollment
Screen referred clients to identify appropriate health insurance options, provide navigation per Affordable Care Act and state regulations, and refer to resources as needed
Assist local communities in applying for Medicaid and Marketplace coverage and advocate for clients on matters with the Federal Marketplace, the state Medicaid agency, and their insurance carrier
Create and revise program documents as needed
Ability to manage multiple priorities with a range of timelines and tasks, being flexible and adjusting as needed
Ability to work in a fast-paced environment while maintaining a high level of attention to detail
Ability to occasionally work on evenings and weekends and travel to outreach locations
Employment dependent upon passing a background check to become a Certified Application Assister and completion of state training for Oregon Health Plan and federal training for Marketplace enrollment. Training is provided.
Paid medical, dental, vision, life, disability, FSA, and 401K match
BS/BA degree or equivalent experience
Proficiency in Microsoft Office and Microsoft 365 (particularly Excel)
Creative and collaborative, with strong analytical and problem-solving skills are essential
Strong, professional communication skills, both verbal and written
Ability to prioritize multiple tasks and meet deadlines
High level of organizational skills
Ability to develop and facilitate training programs
Ability to analyze processes and determine opportunities for improvement
Bilingual and multicultural staff are highly desired
Knowledge/experience working with State agencies and governmental IT platforms may be required
Office space with stairs (no ADA access)
Ability to work from home or in the office
Ability to lift 10-20 lbs.
Frequent use of keyboard, 2 monitors, mouse, telephone and/or headset