Job Description

Pay Range: $22.50 to $32.41 hourly

Would you like to have a career that makes a daily difference in people’s lives? Do you want to be part of a caring, respectful, diverse community? If you answered yes to these questions, keep reading!

HealthPoint is a community-based, community-supported and community-governed network of non-profit health centers dedicated to providing expert, high-quality care to all who need it, regardless of circumstances. Founded in 1971, we believe that the quality of your health care should not depend on how much money you make, what language you speak or what your health is, because everyone deserves great care

The Health Insurance and Services Navigator I ensures HealthPoint patients and community members have access to health insurance and essential support services by assessing eligibility, completing applications, and providing clear, accurate education on insurance and public benefit programs. This role requires the ability to explain complex eligibility determinations, coverage options, and next steps in a way patients can understand and act upon. The Health Insurance and Services Navigator I plays a critical role in reducing uninsured rates, preventing coverage gaps, and supporting continuity of care through accurate enrollment, effective communication, and timely follow-up. This role may require occasional travel between sites to provide coverage as needed.

Compensation is dependent on skills and experience.

Your contribution to the team includes:

• Assist clients with eligibility screening, applications, renewals, and recertifications for Medicaid (Apple Health), Qualified Health Plans, Medicare Savings Programs, Basic Food, Family Planning, and other state or federal assistance programs.
• Explain the basics of health insurance, public benefits, plan options, coverage limits, and patient responsibilities using clear, plain-language communication tailored to the patient’s level of understanding.
• Explain eligibility determinations, approvals, denials, partial approvals, and required next steps, ensuring patients understand outcomes, timelines, and responsibilities.
• Assist patients in selecting insurance plans that best align with their healthcare needs, financial situation, and coverage requirements.
• Provide guidance on eligibility for subsidies and other financial assistance programs when applicable.
• Translate complex insurance and eligibility information, including income thresholds, renewal requirements, managed care assignments, premiums, cost-sharing, and documentation needs, into actionable guidance for patients.
• Verify patient understanding by summarizing outcomes and confirming comprehension of next steps verbally and in writing when appropriate.
• Communicate sensitive or unfavorable information, such as denials or coverage changes, in a respectful, supportive, and solution-focused manner.
• Ensure accurate and timely completion of applications, renewals, plan changes, and insurance assignments, including contacting the Health Care Authority (HCA), Washington Healthplanfinder (Exchange), Public Health, Managed Care Organizations, insurance carriers, or other appropriate state agencies directly on behalf of the patient to resolve enrollment, eligibility, or coverage issues as needed.
• Maintain consistent, complete, and compliant documentation of patient interactions in approved systems, while upholding strict confidentiality and privacy standards in accordance with Exchange, HCA, DSHS, HIPAA, and other applicable health information and data protection requirements.
• Monitor application and renewal status and perform proactive follow-up to prevent delays, denials, or gaps in coverage.
• Identify, analyze, and troubleshoot complex enrollment issues, discrepancies, or coverage concerns, coordinating with external partners and agencies to support resolution when standard processes do not resolve the issue.
• Maintain and develop effective working relationships with external organizations such as the Washington Healthplanfinder (WHPF), Health Care Authority (HCA), Department of Social and Health Services (DSHS), Public Health, and community-based organizations.
• Review, build, and act on reports that may require outreach to specific patient populations, including uninsured, unengaged, and aging-out patients.
• Remain current and actively participate in Annual Enrollment and Open Enrollment periods, including sharing updates, changes, and performance information with sites and serving as a point of contact for questions.
• Represent HealthPoint at community outreach and education events, in person or virtual, as determined by leadership.
• Attend internal and external meetings required of the role, which may include presenting information or sharing program updates.
• Assist in the development and implementation of outreach activities and materials to enhance patient access, enrollment outcomes, and customer service.
• Implement strategies to collect data on service access and enrollment issues through mechanisms such as surveys, questionnaires, reports, and time logs, and identify opportunities to improve current systems.
• This role may require occasional travel between sites to provide coverage as needed.
• Contribute to a positive work environment centered around teamwork, collaboration, and accountability. Demonstrate respectful, professional, and appropriate behavior.
• Demonstrate a commitment to the mission, core values and goals of HealthPoint and its healthcare delivery including the ability to integrate values integrity, wisdom, creativity, cooperation, responsibility, respect into appropriate programs and services.
• Attend and participate in staff meetings, trainings, committees and work group assignments as requested or appropriate.
• Other duties as assigned by supervisor.

Must have’s you’ll need to be successful:

• Bachelor’s Degree with a human service-related focus or one (1) to two (2) years of experience in health benefits or healthcare financial eligibility screening is required or equivalent combination of education and experience.
• Ability to explain complex insurance, eligibility, and public benefit information clearly and accurately to individuals with varying levels of health literacy.
• Ability to translate technical, regulatory, and policy-driven information into plain-language explanations that support patient understanding and informed decision-making.
• Ability to communicate sensitive information in a respectful, culturally responsive, and solution-focused manner.
• Ability to present information effectively in one-on-one and small group settings with patients, community members, and internal staff.
• Ability to define problems, collect relevant information, interpret eligibility and program requirements, and apply appropriate solutions. Ability to adapt to policy changes and resolve enrollment or access issues effectively.
• Proficiency with computer systems and intermediate skills in Microsoft Word, Excel, and Outlook. Ability to learn, navigate, and accurately use multiple eligibility, enrollment, documentation, and reporting systems. Must be comfortable working in a fast-paced, technology-driven environment, managing multiple applications simultaneously, and adapting to system updates and changes.
• Washington Healthplanfinder (WHPF) Navigator Certification required within one (1) month of hire and must be maintained in active status. Active certification includes completion of required ongoing training, testing, background checks, and recertification activities in accordance with Exchange and program requirements.

Proof of vaccination for COVID-19 is required, prior to start. HealthPoint does not accept the Johnson & Johnson COVID-19 vaccine as proof of vaccination. If you have received the Johnson & Johnson vaccine, we ask that you provide documentation demonstrating proof of an alternate COVID vaccine or vaccine series. All new employees are also required to show proof of immunizations and/or immunity to MMR (measles, mumps, rubella), Varicella, annual Influenza and TB QuantiFERON Gold Titer Additionally, if you work in a HealthPoint clinic, Tdap (within last 10 years) is required. Hepatitis B. is required for clinical employees with potential exposure to blood/blood products. All immunizations are a condition of employment. Upon hire, employees must provide proof of their immunizations and/or immune titer results prior to starting or no later than their fifth (5) business day of employment.

Where to gather your records:

• If you are providing immunizations from an electronic health record, please ensure that you obtain a copy of your full records rather than a screenshot. Each page of your records should include your first and last name, date of birth, and the name of the health system from which the records are pulled.
• If records do not show any data, please seek guidance from your provider for further assistance.
• If you are unable to provide proof as noted above, you can choose to have a lab titer drawn to check immunity or to be re-vaccinated. If you receive vaccination(s) or lab titers, you may obtain them through HealthPoint at no cost to you. This is a great opportunity to get your immunization record up to date at no additional expense.

HealthPoint is committed to offering all employees a competitive compensation package, including benefits and several other perks.

• Medical, Dental, and Vision for employees and their families/dependents
• HSA, FSA plans
• Life Insurance, AD&D and Disability Coverage
• Employee Assistance Program
• Wellness Program
• PTO Plan for full-time benefited employees. During 0 - .99 years of service, PTO accrual is 5.23 hours per pay period.
• Extended Illness Time Away of 40 hours
• 8 holidays and 3 floating holidays
• Compassion Time Away up to 40 hours
• Opportunity Time Off (extended time off for staff to invest in themselves) up to 8 weeks
• Retirement Plan with Employer Match
• Voluntary plans at a discount, such as life insurance, critical illness and accident insurance, identity theft insurance, and pet insurance.
• Development and Growth Opportunities

To learn more about HealthPoint, go to www.healthpointchc.org! #practiceyourpassion

It is the policy of HealthPoint to afford equal opportunity for employment to all individuals regardless of race, color, religion, sex (including pregnancy), age, national origin, marital status, military status, sexual orientation, because of sensory, physical, or mental disability, genetic information, gender identity or any other factor protected by local, state or federal law, and to prohibit harassment or retaliation based on any of these factors.