- Explain potential eligibility for public/governmental programs, how the federal health insurance premium tax credit and cost-sharing reductions work, and outline potential risk factor, if any, to consumers.
- Assist consumers with submitting documents and information as required by the Marketplace via scan, fax or mail.
- Regulatory/Compliance
- Securing and safeguarding confidential information to prevent Protected Health Information (PHI) from being obtained from unauthorized personnel to ensure compliance with privacy and security standards.
- Keep abreast of all industry and regulatory updates as it pertains to the ACA and Marketplace.
- Monitor all applications in personal dashboard to ensure timely and accurate follow through from applicants.
- Conduct a daily review of personal dashboard to address and follow-up on any and/or all potential leads for consumers seeking assistance.
- Keep abreast of all the Marketplace functionalities to effectively manage individual accounts.
- Data enter all applicant demographic, enrollment site and PCP selection data in the required "Enrollment Program" within the MetroPlusHealth portal at the time of the initial enrollment encounter.
- Minimum of one (1) year of Sales/Customer Relations experience required.
- Required to work evenings and weekends.
Sales Representative I - New York, NY, United States - MetroPlus
Description
Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics.
For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
The Sales Representative is responsible for educating and assisting qualified individuals with purchasing affordable health insurance coverage and/or obtaining an eligibility determination for coverage in Qualified Health Plans (QHPs) and insurance affordability programs such as Medicaid and Child Health Plus (CHP) through the NY State of Health (MarketPlace).
The Sales Representative is responsible for identifying and educating prospective members that do not have health insurance and/or are looking to change coverage as well as assisting existing members with recertification and education of benefits.
The Sales Representative is tasked with performing all duties in accordance with the Affordable Care Act (ACA) as well as all other pertinent rules and regulations.
Educate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus.