Insurance Eligibility & Enrollment Coordinator

Title: Insurance Eligibility & Enrollment Coordinator

Program: Healthcare Administration

Salary Range: $50,630 per year

Overall Responsibilities:

Project Renewal’s Healthcare Department is seeking a team-oriented, customer-focused, and strong multi-tasker for the Insurance Eligibility & Enrollment Coordinator position! Reporting to the Assistant Administrator of Clinic Operations, the Insurance Eligibility & Enrollment Coordinator works collaboratively with clinic, mobile health, revenue cycle, and other interdisciplinary teams to support patient access to healthcare services through insurance verification, enrollment assistance, coverage navigation, and patient engagement activities. This position serves as a key resource for patients requiring support with health insurance eligibility, enrollment, renewals, coverage maintenance, and resolution of insurance-related barriers to care.

This position follows a hybrid work schedule; however, the incumbent must be able and willing to travel to and provide onsite support at multiple program and clinic locations throughout New York City's five boroughs, based on operational and patient care needs.

Essential Duties and Responsibilities:

The essential duties of the Insurance Eligibility & Enrollment Coordinator include but are not limited to the following activities:

• Eligibility, Verification and Patient Registration
  • Review, verify, and maintain accurate patient demographic, financial, PCP, and insurance information within the electronic health record (EHR), including conducting insurance eligibility verification through ePACES, Marketplace, Medicaid, payer-based systems and other related tools.
  • Scan, upload, and maintain eligibility reports, enrollment documentation, recertifications, applications, correspondence, and supporting documents within the EHR.
  • Partner with Revenue Cycle, Billing, and Clinic Operations staff to ensure data accuracy and support timely claims submission, reimbursement, and resolution of insurance-related issues.
• Insurance Navigation and Coverage Resolution:
  • Assist patients in identifying and resolving insurance-related barriers to care, including enrollment discrepancies, eligibility issues, PCP changes, coverage restrictions, at-limit concerns, and other administrative obstacles, by collaborating with patients, health plans, managed care organizations, and payer representatives and supporting the completion of documentation required to maintain, restore, or optimize coverage and access to service.
  • Monitor and document resolution efforts and conduct ongoing follow-up until identified insurance issues have been addressed whenever possible
• Insurance Enrollment, Renewal and Retention Support:
  • Promote awareness of insurance, financial assistance, and healthcare access resources available to patients.
  • Collaborate with Enrollment Specialists, care managers, social service providers, shelter-based staff, and external partners to support patient enrollment, renewal, and eligibility needs, including providing cross-coverage assistance with Medicaid, Marketplace, managed care, and other insurance enrollment and navigation activities as required.
• Patient Communication and Care Coordination:
  • Conduct patient outreach and follow-up through telephone, electronic communication, mail, and other approved methods to obtain required documentation, and support enrollment and renewal activities.
  • Collaborate with healthcare providers, care managers, social service teams, community partners, and payer representatives to coordinate care, address barriers to healthcare access, and connect patients to appropriate healthcare and community-based resources, utilizing language access services and other engagement tools as needed.
    

Qualifications:

• High school diploma or graduation equivalency degree (GED); Associate’s degree
• Minimum one (1) year of experience in a medical office, healthcare enrollment, patient access, insurance verification, or related healthcare setting.
• Experience working with insurance eligibility systems, payer portals, or patient registration processes
• Basic competency in Microsoft Office applications, including Word and Excel.)
• Strong verbal and written communication skills and professional telephone etiquette.
• Strong organizational, time management, and multitasking abilities.
• Demonstrated customer service and relationship management skills.
• Ability to handle sensitive and confidential information with discretion.
• Experience supporting Medicaid, Marketplace, or other health insurance enrollment programs.
• Knowledge of healthcare registration, insurance verification, revenue cycle, and patient access processes.
• Experience with eClinicalWorks (eCW) or other electronic health record systems
• Bilingual skills, particularly Spanish, preferred.
• Knowledge of community-based healthcare and social service systems