What are the responsibilities and job description for the Specialist Healthcare Enrollment position at St. Joseph's Health?
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.
Qualifications
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”.
Benefits Eligibility: (Full-time and Part-time Employees-over 20 hours a week)
About The Team
St. Joseph’s University Medical Center is an academic tertiary care medical center and state designated trauma center, located on the Paterson campus, regularly accepts referrals of difficult or unusual cases from other hospitals and physicians and performs both complex and routine procedures.
The Medical Center offers a full complement of specialty and subspecialty services including ambulatory, behavioral health, cardiovascular, emergency/trauma, internal medicine, neuroscience, oncology, orthopedic/spine, rehabilitation, surgical specialty, women’s health, imaging and pediatrics.
The nursing team at St. Joseph’s University Medical Center, which includes St. Joseph’s Children’s Hospital, has held the Magnet Award for Nursing Excellence, the profession’s highest honor, since 1999. They are also recipients of the prestigious 2010 Magnet Prize™ - one of only 8 Magnet-designated hospitals to ever receive The Magnet Prize, and the only one worldwide to receive the 2010 award.
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.
Qualifications
- Certified Application Counselor (CAC) for ACA Marketplace Enrollment
- 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”.
Benefits Eligibility: (Full-time and Part-time Employees-over 20 hours a week)
- Competitive salary*
- Robust benefits with health, dental, Rx and vision plans
- 403b retirement plan options with company match**
- Health & Wellness*
- Non-Profit Health System – eligible for Federal Student Loan Forgiveness
- PTO, and paid holidays
- Tuition reimbursement
- Employee Assistance Program
- LTD : Long Term Disability
- Life Insurance Options
- Onsite Day care Program
- Available for Per Diem Employees and Part-time Employees working under 20 hours per week.
- 403b Company Match not applicable for Per Diem Employees and Part-time Employees working under 20 hours per week.
About The Team
St. Joseph’s University Medical Center is an academic tertiary care medical center and state designated trauma center, located on the Paterson campus, regularly accepts referrals of difficult or unusual cases from other hospitals and physicians and performs both complex and routine procedures.
The Medical Center offers a full complement of specialty and subspecialty services including ambulatory, behavioral health, cardiovascular, emergency/trauma, internal medicine, neuroscience, oncology, orthopedic/spine, rehabilitation, surgical specialty, women’s health, imaging and pediatrics.
The nursing team at St. Joseph’s University Medical Center, which includes St. Joseph’s Children’s Hospital, has held the Magnet Award for Nursing Excellence, the profession’s highest honor, since 1999. They are also recipients of the prestigious 2010 Magnet Prize™ - one of only 8 Magnet-designated hospitals to ever receive The Magnet Prize, and the only one worldwide to receive the 2010 award.