Health Insurance Specialist Supervisor - Access To Healthcare Network

Best Place to Work in Northern Nevada - 1st Place Winner 2024
Best Place to Work for Working Parents - 2024

Check out our AWESOME Benefits!

• 4 weeks Paid Time Off in the First Year - Front Loaded
• 14 paid holidays annually
• Hybrid Work Options Available
• 403B Retirement Plan with 4% Match
• 4 Weeks Paid Parental Leave
• Up to 4 Weeks Paid Catastrophic Leave
• Medical, Dental, and Vision benefits - effective 1st DAY OF THE MONTH, following date of hire
• Free Health Insurance Options for Full Time Employees
• Low-Cost Health Insurance Options for Dependents
• Health Reimbursement Account
• Employee Hardship Loan Program
• Free Life Insurance and Long-Term Disability
• Tuition Assistance
• Continuing Education Support
• Dog Friendly Workplace
• Child Friendly Workplace
• Great Organizational Culture!

JOB PURPOSE: The Ryan White Health Insurance Supervisor is responsible for maintaining the highest professional and ethical standards in representing Access to Health Network (AHN) to Ryan White clients and community partners. The Ryan White Health Insurance Supervisor will provide support, direction, standardization and prioritize daily activities and tasks for Claims Processors and Insurance Specialists. The ideal candidate is a motivated, hard-working, and organized individual who performs well under pressure and can multi-task. This position is responsible for assisting Ryan White clients who may qualify for insurance through an employer, Medicaid, Medicare, and the Nevada Exchange as well as payments for insurance premiums and/ or medical, dental, and vision cost share.

BASIC REQUIREMENTS:

• Bilingual (English/Spanish) mandatory.
• Required to pass a background check through the State of Nevada.
• Abide by all HIPAA requirements.
• Must have a valid driver's license and be able to drive the AHN company car when needed.
• Must be able to obtain an Exchange Enrollment Facilitator License (EEF) within 90 days at the agency's expense.
• Required to obtain a Community Health Worker Certification within the first quarter of employment at the agency's expense.
• Required to obtain Medicare Assistance Program MAP license within the first six months of employment at the agency's expense.
• Gain a clear and basic knowledge of Access to Healthcare Network administrative duties, services, and systems.
• Gain and maintain a general working knowledge of health insurance systems and terminology.
• Gain a clear and working knowledge of the software system used in tracking demographics, service data, case management, and member referrals.
• Must attend staff meetings and be willing to meet with direct supervisor consistently.
• Effectively communicate with all AHN departments, as needed.

KEY RESPONSIBILITIES AND ACCOUNTABILITIES:

• Point person for Insurance Specialists and Claims Processors.
• Oversee quality, performance, and training standardization with support from the Health Insurance Assistant Director.
• Ensure that staff tools and resources are current.
• Responsible for state reporting.
• Maintain Insurance Specialist and Claims Processors staff schedule including approving timecard and time off.
• Delegate and ensure all inquiries and follow-up tasks are completed appropriately and within the designated timeframe.
• Participates in program development.
• Gather information from AHN Ryan White clients to determine eligibility for specific insurance products.
• Gain a general working knowledge of Nevada/Federal Health Exchange, CMS & Medicare Programs, Health Insurance Programs, Access to Healthcare Network, State Health Insurance Subsidies/Assistance Programs, and Medicaid including the eligibility criteria and enrollment process.
• Fulfill parts of the Scope of Work for the Nevada Department of Health and Clark County Nevada.
• Ensure that the Ryan White Part B files are up to date with the necessary documents.
• Accurately and efficiently record all pertinent client information into CAREWare and Salesforce.
• Eligibility screening for potential Ryan White services to ensure clients are eligible for assistance.
• Perform detailed and accurate review of all applications that may qualify for insurance.
• Maintain and process Health Insurance Premium, Medicare Part C/D, and Employer premium payments.
• Implement critical thinking abilities with an emphasis on research skills and resourcefulness.
• Ability to describe and communicate complex concepts.
• Ability to be both compassionate and professional while serving our population and interacting with staff.
• Always treat AHN clients and prospective clients with respect and dignity.
• Flexibility; ability to adapt to changing work environment and duties. Each department selects the hours of work schedule for the department staff based on the department's needs. This schedule may change at any time according to the department's needs.
• Other duties as assigned.

EDUCATION MINIMUM:

• Minimum Education: High School Diploma.
• Bachelor's degree in social work, public health administration, sociology, psychology or related field preferred.

EXPERIENCE MINIMUM:

• One year minimum working in health care related social work, with experience in medical billing and patient coordination preferred.
• Two years working with special needs populations combined with knowledge and understanding of case management.
• Two years minimum computer experience including: Microsoft operating systems, word processing, spreadsheets, database input, and report generation.
• Demonstrated experience in planning and execution of organization communication.
• Excellent communication skills - oral, written and verbal.
• Excellent customer service and organizational
• Quick and accurate data entry skills.
• Ryan White experience mandatory.
• Case Management experience preferred.
• Community Health Worker (CHW) certified preferred.
• Stanford Chronic Disease Training preferred but not mandatory.
• Chronic Disease Self-Management Program (CDSMP) preferred but not mandatory.

WORK ENVIRONMENT:

• The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office environment.
• Be able to sit at a computer for 6 - 8 hours per day.
• Be able to stand between 3 - 6 hours per day.
• Be able to withstand hand/wrist deviation and repetition.
• Must be able to lift, carry up to 30 pounds with a fair consistency.

The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified. As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network. Furthermore, they do not establish a contract or implied contract for employment.

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds.

We encourage all qualified candidates to apply.