Healthcare Enrollment Specialist
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Job Description
Responsible for assisting patients enroll in health insurance coverage and ensure they maintain accurate and timely eligibility. Support patients applying for health coverage through Healthcare.gov or state-based exchanges or through NJ Medicaid. Guide patients through choosing appropriate plans, completing required documentation, and navigating plan rules and deadlines. This role involves working closely with state health agencies, healthcare providers, and patients to ensure eligibility is accurately determined and documented.
- 3 to 5 years of experience in healthcare enrollment
- High school diploma or equivalent required
- Associate's degree in healthcare administration, public health, or related field preferred
- Bilingual fluency, particularly in Spanish, is highly preferred
- Working knowledge of health insurance terminology and plan structures (e.g., PPO, HMO, etc.)
- Proficiency in enrollment platforms and data entry systems
- Familiarity with HIPAA and ACA compliance requirements
- Ability to interpret and apply eligibility criteria and federal/state healthcare regulations
- Basic understanding of EDI (electronic data interchange) in healthcare
- Empathetic, patient-first communication style
- Strong attention to detail and accuracy in data handling
- Analytical thinking and problem-solving for eligibility questions
- Adaptability to regulatory and process changes
- Possesses and demonstrates excellent communication, organizational, technical, and interpersonal skills
- Ability to handle sensitive or confidential information with discretion
- Strong knowledge of Medicaid and Charity Care eligibility guidelines
- Previous work in a hospital, managed care organization, or insurance company
- Experience enrolling individuals in government or public health programs
St. Joseph's Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".
Automate your job search with Sonara.
Submit 10x as many applications with less effort than one manual application.
