Enrollment Service Representative Bilingual Spanish

Job Description

JOB RESPONSIBILITIES:

1. Conducts face-to-face outreach and enrollment broker services to beneficiaries in a group and individual presentations.

2. Presents Managed Care Options to beneficiaries and assists them in using their health care

plans.

3. Assists beneficiaries in the enrollment/disenrollment process.

4. Assists other Enrollment Service Representatives with daily management duties.

5. Assists management with the training/guidance of new Enrollment Service Representative staff.

6. Maintains positive relationships with the county staff, community groups and HCO clients; conducts on-going training of HCO program to county staff.

7. Performs data entry for enrollment/disenrollments, as needed.

8. Transmits enrollment/disenrollment data to central processing facility operations in accordance with HCO policies and procedures.

9. Assists beneficiaries with medical exemptions and waiver inquiries.

10. Provides beneficiaries with status of enrollment/disenrollment, medical exemptions and waivers.

11. Documents daily activity accurately in Customer Relationship Management Database

12. Reviews knowledge base content for accuracy and makes recommendations for improvement.

13. Adheres to established procedures, performs self-checking and pay attention to detail in the performance at work.

14. Meets Field Operations minimum performance standards.

15. Notifies management in a timely manner of any problems with procedural compliance using established processes.

16. Reports observed quality problems and deficiencies in a timely manner.

17. Makes recommendations to management for improving the quality and efficiency of work.

18. Meets Production and Quality Assistance goals as defined for this position.

19. Ability to work any and all assigned offices as directed by management.

20. Ability to attend and promote the program during community events and health fairs as needed.

21. Meets all standards established for this position as outlined in the attached performance criteria.

22. Performs other duties as may be assigned by management.

JOB ENVIRONMENT:

Work is constantly performed in an office environment.

EDUCATION/EXPERIENCE/ADDITIONAL REQUIREMENTS: High School diploma, GED, or equivalent certification; knowledge of the community to be served; Computer literacy; ability to work with MS Office (Excel, Word, PowerPoint); ability to quickly learn new software programs. Type 20+ wpm; ability to travel (valid CA driver’s license and evidence of insurance required) throughout the county and surrounding counties as needed, in a dependable and punctual manner; excellent organizational, interpersonal, written, and verbal communication skills; ability to perform comfortably in a fast-paced, deadline-oriented work environment; ability to successfully execute many complex tasks simultaneously; and ability to work as a team member, as well as independently; and fluency in threshold languages including reading and writing ability. Preferred qualifications include six months of human services experience dealing with the public. Presentation and/or public speaking experience (teaching, marketing, community outreach and education, or public relations experience). Experience working with low-income and diverse populations; Capable of presenting the required information and materials interactively and in a culturally and linguistically competent manner that readily lends itself to comprehension and retention by beneficiary being served.

Employees must be fluent in Spanish and English.

Employees must have a valid and current CA driver's license to operate a personal vehicle while on company business.

Motor vehicle records will be obtained on all drivers upon employment and no less than every six months thereafter.

A driving record that fails to meet the criteria stated below means the employee is no longer eligible for placement.

Personal vehicles used for company business must have appropriate insurance coverage. Personal auto insurance is the sole responsibility of the employee. Minimum coverage of $250,000 Combined Single Limit (CSL) is required.

Employees are expected to drive in a safe and responsible manner and to maintain a good driving record.

Criteria that may indicate an unacceptable record includes, but is not limited to:

• Three or more moving violations* in a year
• Three or more chargeable accidents within a year. Chargeable means that the driver is determined to be the primary cause of the accident through speeding, inattention, etc. Contributing factors, such as weather or mechanical problems, will be taken into consideration.
• Any combination of accidents and/or moving violations.