Internal Posting - Health Insurance Specialist Supervisor - Bilingual

TITLE: Health Insurance Specialist Supervisor

REPORTS TO: Assistant Director

SUPERVISES: Insurance Specialists and Claims Processors

BASED AT: Access to Healthcare Network- Las Vegas

STATUS: Exempt

Job Purpose

The Health Insurance Specialist Supervisor oversees daily operations for Eligibility Specialists with insurance duties and Claims Processors. This role ensures high-quality service to Ryan White clients through leadership, workflow oversight, training, and accurate insurance eligibility and enrollment support. The Supervisor also maintains compliance with reporting requirements, manages premium payments, and ensures timely and accurate documentation in agency systems.

Key Responsibilities

Team Leadership & Operations

• Serve as primary point of contact for Eligibility Specialists and Claims Processors.
• Oversee quality, performance, training, and standardization in partnership with the Assistant Director.
• Maintain updated tools, resources, SOPs, and workflows.
• Manage staff schedules, approve timecards and time-off requests.
• Delegate tasks and ensure inquiries and follow-up items are completed within required timeframes.
• Participate in program development and continuous improvement efforts.

Client Eligibility & Insurance Support

• Collect client information to determine eligibility for insurance programs (Medicaid, Medicare, employer plans, Nevada Exchange).
• Conduct eligibility screenings for Ryan White Part B services.
• Review insurance-related applications for completeness and accuracy.
• Maintain and process premium payments (Health Insurance, Medicare Part C/D, employer plans).
• Ensure Ryan White Part B files are complete and up-to-date.
• Fulfill required components of the Nevada Department of Health and Human Services subgrant Scope of Work.

Documentation & Systems

• Enter accurate, timely client information into CAREWare and Salesforce.
• Maintain working knowledge of insurance systems, terminology, and enrollment processes.
• Ensure compliance with HIPAA and confidentiality policies.
• Communicate effectively with internal departments and external partners as needed.

Other Requirements

• Develop and maintain working knowledge of Nevada/Federal Health Exchange, CMS & Medicare programs, Medicaid, subsidies/assistance programs, and AHN services.
• Apply critical thinking, research skills, and resourcefulness in client and program support.
• Communicate complex concepts clearly and professionally.
• Maintain professionalism and compassion when interacting with clients and staff.
• Attend staff meetings and meet regularly with the Assistant Director.
• Adapt to changing work duties, schedules, and program needs.
• Obtain required certifications (agency-funded):
  • Community Health Worker Certification (within first quarter)
  • Exchange Enrollment Facilitator License (within first quarter)
  • Medicare Assistance Program (MAP) License (within six months)
• Perform other duties as assigned.

Qualifications

Education

• Bilingual- Spanish/English required.
• High School Diploma required.
• Bachelor's degree in social work, public health, sociology, psychology, or related field preferred (or equivalent education/experience).

Experience

• Minimum one year in healthcare-related social work OR two years working with special needs populations with case management knowledge.
• Ryan White program experience required.
• Case management experience preferred.
• Minimum two years of computer experience (Microsoft Office, database systems, reporting).
• Strong oral and written communication skills, customer service aptitude, organizational skills, and data entry accuracy.
• Preferred: CHW certification, Stanford Chronic Disease Training, Chronic Disease Self-Management Program training.

Additional Requirements

• Must pass Nevada background check.
• Valid driver's license and ability to drive AHN vehicle.
• Ability to sit 6-8 hours/day, stand 3-6 hours/day, perform repetitive hand/wrist motions, and lift up to 30 lbs.
• Flexibility in scheduling based on departmental needs.

Grant Funding Clause

This position is dependent on grant funding. Duties, hours, compensation, and continued employment may change if program requirements or funding levels change.

Benefits:

• Medical Insurance & Vision provided at no cost to the Employee
• Health Savings Account HDHP (HSA) includes employer matching $35.00 per month
• Dependent Care Flexible Savings Account (FSA)
• Low-cost health insurance options for your dependents
• Prescription drug insurance
• Dental insurance
• Free Life Insurance and Long-Term Disability
• Voluntary Ancillary Benefits
• 4 Weeks Paid Time off in your first year
• WFH Options
• 14 Holidays
• Bereavement Leave
• 4 weeks Paid parental leave
• Tuition Assistance and more!

Required to pass a background check through the State of Nevada