Insurance Access Specialist

Weekdays, 1st Shift

Job Summary:

The Insurance Access Specialist plays a vital role in ensuring that clients of The Brien Center have appropriate, continuous, and active health insurance coverage. This position is responsible for identifying and assisting clients who are uninsured, underinsured, or facing insurance-related challenges. The Specialist will provide hands-on, individualized support throughout the insurance application, renewal, and problem-resolution processes, with the goal of eliminating barriers to care and supporting clients in navigating a complex insurance landscape.

Essential Job Functions:

• Proactively identify clients who are:

• Uninsured

• Enrolled in incorrect or insufficient plans

• Approaching lapse or expiration of coverage

• Provide direct, individualized support to clients in:

• Applying for MassHealth or other appropriate insurance plans

• Renewing or updating existing coverage

• Addressing discrepancies in eligibility or enrollment

• Understanding coverage options, including payment plans and gap insurance

• Liaise with MassHealth, the Health Connector, Medicaid, and other insurance agencies to resolve client-specific issues

• Serve as a resource for clinical teams by:

• Educating staff on insurance navigation basics

• Collaborating to address client barriers related to coverage

• Track and document all client interactions, outcomes, and follow-up steps in compliance with agency standards and privacy requirements

• Maintain up-to-date knowledge of public and private insurance programs, including eligibility criteria and application procedures

• Conduct outreach and provide education regarding upcoming insurance changes, renewal deadlines, and related topics

• Participate in cross-departmental initiatives aimed at improving client access to benefits and services

Qualifications, Experience, and Education:

• Associate's or Bachelor's degree in Human Services, Social Work, Public Health, or related field preferred
• Minimum of 2 years of experience working with public benefits, health insurance programs, or in a case management setting
• Working knowledge of MassHealth, the Massachusetts Health Connector, Medicaid, and other health insurance programs
• Strong interpersonal and communication skills; ability to build rapport with clients who may be in crisis or face systemic barriers.
• Bilingual or bicultural candidates strongly encouraged to apply
• Proficiency in Microsoft Office and familiarity with electronic health records or case tracking systems
• Demonstrated organizational and problem-solving skills; ability to manage multiple cases simultaneously

Required Certification:

• Successful completion of employer-sponsored MassHealth CAC (Certified Application Counselor) training is required within six months of employment. This training equips professionals with the skills to assist clients in enrolling in health coverage through the Massachusetts MassHealth program and the Health Connector

Skills and Knowledge:

• Excellent communication and collaboration abilities.
• Strong organizational skills with the ability to communicate with clients.

Working Environment and Physical Requirements:

• Standard work week with occasional flexibility required for weekend hours for client or program needs
• Regular use of computers and other technology is required, with reasonable accommodation available as needed to perform essential functions