SUMMARY OF ORGANIZATION / POSITION:
Since 1990, Community Research Initiative has operated the HIV Drug Assistance Program (HDAP)/Comprehensive Health Insurance Initiative (CHII) under contract with the Massachusetts Department of Public Health. This program, funded by both federal and state dollars and one of the largest programs of its kind in the country, provides access to HIV/AIDS medications to under- or uninsured clients. The program also provides health insurance for individuals with HIV/AIDS who are otherwise unable to access coverage.
The CHII Enrollment Specialist assists in the coordination of the operations and functions of HDAP’s Comprehensive Health Insurance Initiative program (CHII), including enrollment, service delivery, vendor relations, billing, quality assurance, fiscal monitoring, program evaluation, and reporting. The CHII Enrollment Specialist: serves as liaison between the HDAP/CHII program and clients, case managers, providers, contracted vendors and private/public health insurance representatives; assists the CHII Program Coordinator and Manager, as needed, in operations and functions of the HDAP/CHII database, including data collection, data entry, maintenance, reformatting and adaptation, troubleshooting, and evaluation; and assists in program reporting, including preparation and review of data, utilization, and fiscal reports (as needed).
EDUCATION AND TECHNICAL TRAINING: Bachelor’s degree; Associate's degree and equivalent work experience may be considered in lieu of four-year degree.
EXPERIENCE: At least two years’ experience in a position providing administrative support and customer service.
SKILLS NEEDED/OTHER: Excellent organizational and managerial skills; interest and experience in client/customer service; expertise in Microsoft Access, QuickBooks, Excel and Word; ability to work closely with a diverse staff; ability to work with a flexible approach to multiple priorities; knowledge of public and private health insurance programs, including individual and group coverage, Medicaid/MassHealth, and Medicare; interest in and/or knowledge of HIV/AIDS, social services, and public entitlement programs; strong interpersonal, written, and oral communication skills; attention to detail. Spanish-, Portuguese-, and/or Haitian Creole-speaking a plus.
Accountability: This position reports to: CHII Program Manager
DUTIES AND RESPONSIBILITIES:
· Works closely with screening and enrollment staff to assess, counsel and enroll eligible applicants in the CHII program. Assists clients as necessary.
· Assists in semi-annual re-certification of client eligibility. Contacts clients with missing information in fulfillment of program requirements. Answers any questions or problems involving billing issues.
· Advocates for individual clients with health insurers, health care providers and others to ensure full utilization of benefits and resolution of any billing issues.
· Handles CHII daily, weekly, and monthly functions. Tracks and monitors credits, overdue balances, increases in premiums or any other changes in order to ensure accurate and complete data on client and insurer status.
· Works closely with business office and contracted vendors on an ongoing basis. Inputs information regarding new and current CHII payments into HDAP database for third-party processing and maintains detailed accounts of all CHII fiscal transactions.
· Handles monthly functions in CHII. Records all CHII payments to insurance providers, MassHealth/Medicaid, Medicare, COBRA administrators, and employers for employee contribution plans.
· Maintains thorough and up-to-date knowledge of available public and private health insurance programs and options. Keeps informed of policies and procedures of insurance purchase and continuation programs.
· Works with fellow staff to support outreach, education, and training of health care providers, case managers, and consumers in program features, application and enrollment processes, and changes in health insurance landscape, as needed.
· Works closely with HDAP/CHII Data Operations Manager to identify and address issues related to the efficient operation and maintenance of CHII program, data operations, and reporting functions.
· Assists with coordination of Affordable Care Act Advance Premium Tax Credit reconciliation.
· Performs other duties, as needed.
Community Research Initiative (CRI) is an independent, nonprofit community-based organization dedicated to leading the way in HIV/AIDS and hepatitis C clinical research, ensuring access to life-saving medications and providing financial assistance for approved drug treatments and health insurance coverage for those in need.
CRI is an affirmative action/equal opportunity employer committed to diversity in the workplace. For more information about CRI, visit our website at: www.crine.org
Salary commensurate with experience. Compensation package includes salary, health care coverage (dental and vision also available), disability and life insurance. Generous paid vacation benefits and professional development opportunities.
Minimum Education Required