Class Specification

 Insurance/Enrollment Specialist

General Purpose

Performs varied children’s health insurance enrollment related duties including responding to requests for information; generating interest in enrollment through outreach, application assistance and follow-up; documentation of activities; access, utilization, and retention activities; and related tasks.

DISTINGUISHING CHARACTERISTICS

Enrollment Specialists are responsible for a variety of children’s health insurance enrollment support functions that require knowledge of the terminology, procedures and practices for their functional areas, with a degree of independence and accountability for results. Enrollment Specialists also assist clients and service providers to access, utilize, maintain, and deliver children’s support services.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The duties listed below are intended only illustrations of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to this class.  There will typically be an assigned schedule for these duties.

• Applies health insurance guidelines to determine client and provider eligibility for participation. Assists eligible clients and service providers to establish and maintain program participation.
• Provides telephone and in-person assistance to complete insurance and related applications.  Advises clients of the documentation required to complete applications, and answers questions and issues regarding the enrollment process.
• Serves as a liaison to insurance and other service providers.
• Facilitates outreach and education on program services.  Coordinates district-wide insurance campaigns.
• Works in conjunction with district case mangers to link health insurance and other services to children.
• Prepares all related reports and maintains files, data bases and other program records.

Qualifications

Knowledge of:

Rules and regulations affecting children’s health insurance and related programs; principles and practices of sound business communication; correct English usage, including spelling, grammar and punctuation; school district organization, ordinances, rules, policies and procedures applicable to departmental operations; uses of word processing, spreadsheet, and other standard software; recordkeeping and filing.

Ability to:

Ability to communicate (by telephone, email, and in person) and work effectively with a variety of people; work independently; meet required timelines; prepare clear, accurate and concise records and reports; travel to various locations; maintain a flexible work schedule; ability to deal with sensitive situations; work with school staff and others encountered in the course of work.

Education, Training, and Experience:

High School diploma or G.E.D. equivalent.  Certified Application Assistant Certificate highly desirable. One to three years of experience with children’s services programs or equivalent combination of training and experience. Experience in a school setting is highly desirable.

A valid California Class C driver's license, a good driving record and the ability to maintain insurability under the District’s vehicle insurance policy.

Upon acceptance of the District’s offer of employment, new hires may be required to complete a baseline physical examination prior to the first day of employment.

Skills

Operate a computer and standard office equipment; type accurately at 40 awpm; learn and apply new information and skills

Physical and Mental Demands

The physical and mental demands described here are representative of those that must be met by employees to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands

While performing the duties of this job, employees are regularly required to sit, walk and stand; talk or hear, both in person and by telephone; use hands repetitively to finger, handle, feel or operate standard office equipment; reach with hands and arms; and lift up to 25 pounds.

Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus.

Mental Demands

While performing the duties of this job, employees are regularly required to use written and oral communication skills; read and interpret data, information and documents; analyze and solve non-routine office problems; use math and mathematical reasoning; observe and interpret situations; learn and apply new information or skills; perform detailed work on multiple, concurrent tasks; work under deadlines with frequent interruptions; and interact with administrators, faculty, staff, parents, students, the public and others encountered in the course of work.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this class.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Employees typically work in a school or administrative office, and the noise level can be occasionally loud.