Job Description

Job Description: Health Insurance Enrollment Specialist About the Organization ASHwell is a nonprofit, sexual health clinic and social wellness center established in Austin, TX in the late 1980s. Clinically, we specialize in HIV treatment and prevention, Hep C treatment and STI treatment and management. Socially, we specialize in providing programming, resources and services to overcome barriers to health access with the goal of building Health Equity in Austin and Central Texas. ASHwell prioritizes providing a safe, welcoming and discrimination-free space for all, predominantly serving LGBTQIA+ and BIPOC communities. Our approach to sexual health and wellness is rooted in being a proudly sex and kink positive, pro-sex worker, pro-harm reduction and anti-stigma organization that is passionately committed to diversity, equity, and inclusion. We are a growing organization looking for values-aligned, pro-sexual health and wellness people to join our team! Position Overview The Health Insurance Enrollment (HIE) Specialist guides incoming ASHwell patients through the health insurance enrollment process. They identify the health insurance plan best suited to meet the patient's need, and they facilitate enrollment via the ACA Marketplace. The HIE Specialist maintains consistent communication with and between the patient, providers, pharmacies, Marketplace, insurance company to ensure coverage, pre authorizations and more. They constantly monitor and track premium payments in collaboration with the finance department. The HIE Specialist also facilitates connections to other ASHwell programs and services. Core Responsibilities Enrollment - 40% 1:1 meeting with patients for the initial phase of the health insurance enrollment process via remote or in person Protect confidential consumer information Facilitate enrollment by selecting an appropriate plan for treatment completing the enrollment process Determine and verify premium eligibility Provide information and education about the Affordable Care Act Provide ongoing support, address questions, and assist with annual renewal processes Gather essential information and enroll patients in ACA healthcare plan Refer to Intake Specialists to clinic appointment and initial intake Ensure documentation is accurately and consistently captured at the time of enrollment. Provide primary care provider (PCP) assistance and medication verification assistance during enrollment Provide one-on-one support to help clients navigate insurance coverage, copay programs, and patient assistance programs as needed Attend mobile unit patient enrollment as scheduled for ASHwell on Wheels Collaborate with the Finance Department to ensure payment for premiums where applicable Communication - 30% Maintain ongoing and as needed communication with enrolled patients, health insurance companies and pharmacies Maintain consistent communication with the Intake Specialist team to: ensure efficient transition to clinical appointments efficient oversight of eligibility status Timely management of and response to calls and emails from patient's providers and pharmacies Maintain consistent communication with the finance department to ensure timeliness of payments and troubleshooting for payment issues Maintain ongoing and as needed communication with ASHwell providers Build and maintain relationships with referring partner organizations Provide Insurance Navigation Support for new patients to understand and leverage their health insurance Tracking & Reporting - 20% Track enrollment and status for each patient including records of customer service, and plan options Track payment needs and deadlines in collaboration with the finance department Produce monthly and quarterly status reports that detail initial enrollment to clinic appointment completion, plan type, plan and payment changes Track and gather all necessary documentation from patients Track and gather all required Marketplace documents in timely manner with attention to varying deadlines Track and coordinate patient insurance verification / eligibility verification needs Collaborate with Intake Specialists to track appointments completion and continued eligibility for ASHwell premium assistance Track and stay up to date on latest changes in regulations to ensuring compliance with applicable guidelines Baseline - 10% Participate in all required staff / team meetings and retreats Maintain up-to-date calendar and work plan Utilize organization wide systems and protocols for all organizational business Prepare and attend weekly check-ins with supervisor Adhere to all ASHwell cultural and operational guidelines and policies Required Qualifications 1+ yrs experience navigating the insurance marketplace 2+ yrs experience working in nonprofit sector 2+ yrs experience working with marginalized communities OR lived experience 2+ yrs Client/Patient/Customer service experience of any kind Prior experience with client/patient databases Working knowledge of Affordable Care Act (ACA) Ability to effectively organize, track and prioritize tasks Strong verbal and written communication Ability to effectively manage time and re-prioritize tasks as needed for a constantly shifting insurance landscape Highly adaptable and can meet needs from a wide spectrum of patient circumstances including language, literacy, and level of experience navigating health insurance Proficiency with digital tools and platforms: Microsoft Teams, MS Office Suite, OneDrive, and Zoom Proficiency in Microsoft Office Suite - Teams, Word, Excel, OneDrive, PowerPoint Lives in Austin, TX or within the greater Austin Metro Area or within 50 miles of ASHwell headquarters at 3800 Red River In depth understanding of gender and sexual orientation spectrums High comfort level working in a pro-pleasure, pro-sex, pro-kink and pro-queer environment Baseline understanding of Harm Reduction and need for HIV de-stigmatization Alignment with ASHwell values of race and gender justice, sexual and reproductive health equity Preferred Qualifications Prior experience of experience with HIPPA compliant databases or CRMs such as Athena, Apricot, etc. HIPPA Compliance Certification Prior experience as a Health Insurance Enrollment Specialist or similar role Bilingual - English & Spanish Prior experience with Patient Assistance Programs (PAP) Prior experience with Athena or Apricot Knowledge of Marketplace 1095-A Tax credit Prior experience with an AIDS Services Organization About You ASHwell's Health Insurance Enrollment Specialist is a detail-oriented people helper who enjoys problem solving. They have worked with and understand the complexities of supporting individuals from marginalized communities and are able to adapt their approach to meet individual's needs to help access and navigate thier health insurance. They understand the complexities health insurance and understand the barriers people face in navigating their health care coverage. Our Health Insurance Enrollment Specialist is excited to work in an openly pro sex & kink forward environment. They are detail oriented, patient, and can be counted on to manage their time well, document thoroughly, organize their tasks/projects, and report weekly, monthly and quarterly on various aspects of their work to their supervisor and collaborators. Our Hiring Process The start date for this position is July 23, 2025 Applications are due no later than midnight CT on June 6, 2025. We are committed to offering the support, time and resources necessary to on-board and orient to the role. TIMELINE Applications Due June 6, 2025. Invitations to interview:Interviews will be scheduled on a rolling basis based on application submissions. Round 1 Interviews: week of June 2, 2025. Round 2 interviews: June 9, 2025. Final interviews: June 16, 2025. Goal date for offers: June 19, 2025. Position start date July 23, 2025. ASHwell uses a cohort onboarding model. The start date kicks off three days of group orientation for hires across the organization.

EQUAL OPPORTUNITY EMPLOYER

As an Affirmative Action and Equal Opportunity Employer, ASHwell is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people ASHwell

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Remote job, Shift work, Night shift,

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