Health Benefit Rep (Bilingual Bengali, Spanish)

Community field based travel position covering Queens County, NY. Educate prospects and members on New York State of Health coverage options, support new enrollments and renewals, and prioritize enrollment growth through trust and accountability. Bilingual - English/Spanish or Bengali Highly Preferred.

• Educate and assist individuals with enrolling in coverage through the NY State of Health Marketplace, including Medicaid (NYM), Child Health Plus (CHP), Essential Plan (EP), Qualified Health Plans (QHP), and Health & Recovery Plan (HARP).
• Explain eligibility for public programs, federal premium tax credits, and cost-sharing reductions, including potential impacts to consumers.
• Teach members about Fidelis digital tools (member portal, mobile app)
• Describe plan features, benefits, and cost-sharing mechanisms (deductibles, co-pays, co-insurance) and how these affect consumers.
• Explain metal tiers within the Marketplace and how benefits vary by income level.
• Assist consumers with submitting required documents via scan, fax, or mail.
• Support existing members with renewals and recertifications.
• Help consumers with premium payment submissions when required.
• Provide culturally and linguistically appropriate assistance.
• Conduct public education activities and presentations to raise awareness of Fidelis Care products and Marketplace options.
• Participate in ACA forums, workshops, and community events as requested.
• Maintain a daily tracking tool that entails detailed rep activity.
• Monitor all applications in personal dashboard to ensure timely and accurate follow through from applicants.
• Conduct a daily review of personal dashboard to address and follow-up on any and/or all potential leads for consumers seeking assistance.
• Keep abreast of all the Marketplace functionalities to effectively manage individual accounts.
• Follow-up on all new potential enrollment leads and consumer inquiries. Record all follow-up dispositions in a timely and accurate manner within the required "CRM".
• Data enter all applicant demographic, enrollment site and PCP selection data in the required "CRM" at the time of the initial enrollment encounter.
• Must be in compliance with all conflict-of-interest standards and regulations.
• Required to work evenings and weekends.
• Secure and safeguarding confidential information to prevent Protected Health Information (PHI) from being obtained from unauthorized personnel to ensure compliance with privacy and security standards.
• Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Marketplace.
• Participate in all trainings, updates and webinars and other forums in which information is necessary to carry out roles and responsibilities.
• Mandated to meet the annual Marketplace Facilitated Enroller (MFE) recertification requirements.
• Keep abreast of all industry and regulatory updates as it pertains to the ACA and Marketplace.
• Maintain discretion regarding business-related files, reports, and conversations within the provisions of applicable State and Federal Statutes and regulations.
• Perform all other tasks and responsibilities as required to satisfy the expectations of the role.
• Performs other duties as assigned.
• Complies with all policies and standards.

Additional Experience/Skills

• Bilingual - English/Spanish or Bengali Highly Preferred
• Bilingual - English/All second languages
• Community Outreach
• Front Facing
• Field Sales
• CAC Certification preferred
• MS Office Suite
• Salesforce
• Public

Work Schedule: Mon. - Fri. with occasional evenings and weekends

• Must have a High School Diploma or GED
• 2+ years of prior experience in managed care, sales, customer service or related experience preferred
• Must have basic computer skills