JOB STATEMENT

The Navigator II is responsible for assisting patients with the clinic registration process and the enrollment to different local, state, and federal health coverage programs. This role requires a deeper understanding of community resources and the ability to handle a higher volume of clients with diverse needs.

JOB FUNCTIONS

• Assists individuals enrolling in clinic sliding fee, Medicaid, CHIP, Marketplace/ACA health plans, or other qualified programs.
• Provides patients with information about insurance affordability programs and coverage options.
• Educates patients about insurance including deductibles, co-insurance, and premiums.
• Interviews benefit recipients at specified intervals to certify their eligibility for continuing benefits.
• Interprets eligibility requirements, application details, and legal rights.
• Compiles records and evaluates personal and financial data.
• Troubleshoots and helps resolve more complex customer complaints or concerns.
• Works with team members to identify system and workflow improvements to enhance efficiencies.
• Keeps records of assigned cases and prepares reports.
• Build and maintain strong relationships with community partners and represent the organization at community events.
• Participates in quality and performance improvement activities.
• Serve as a mentor or resource to Navigator I staff.
• Performs other tasks as required by supervision.

JOB QUALIFICATIONS

• Education : * High School Diploma or equivalent * * Specialized Training/Certifications/Licenses : * Certified Application Counselor (ACA) Certification preferred * Federally Facilitated Marketplace (FFM) Assister Training preferred * Community Partner Program (CPP) Training preferred
• Experience : * 4 yrs. Eligibility Experience; or * 2 yrs. Eligibility Experience + Associate's Degree * 0 yrs. Eligibility Experience + Bachelor's Degree
• Knowledge: * Health insurance regulations and enrollment procedures preferred.
• Skills : * Computer Literacy * Microsoft Office (Word, Excel) * Customer Oriented * Confidentiality * Effective Communication * Fluent in English, Spanish is a plus.
• Abilities : * Must be able to speak, read, write, and comprehend the English language. * Ability to sit for majority of the shift. * Must be able to bend or stoop. * Must be able to lift 20 lbs. unassisted. * Must have good vision (e.g. near acuity and depth perception)
• Other : * Must be able to periodically work on Saturdays. * May require some local travel between different clinic locations. * Must be able to maintain required immunizations as required by the organization. * Must be able to obtain/maintain required certifications within 90 days of hire (training will be provided). * Must be able to pass Texas Health Department background to assist with state program applications.