Benefits Specialist; Outreach & Enrollment; 363

About the Role

This position plays an important role in advancing our mission and supporting the communities we serve. As a facilitator, you will link and follow up between clients, staff, and various organizations such as the Cuyahoga County Department of Human Services, Social Security, the Marketplace, The Children’s Health Insurance Program (CHIP), and other benefits providers.

Responsibilities

• Provides clients with information and assistance regarding entitlements and explains eligibility.
• Assists clients with completing forms, applications, referrals, and submits documentation.
• Works with clients to complete the agency Financial Investigation process (FEE) and explains financial contracts.
• Verifies insurance coverage and obtains documentation of insurance coverage.
• Applies sliding fee when appropriate and completes ADAMHS “Shares” program process, including Diagnostic entry and UCI billing numbers.
• Actively works to ensure continued benefits for clients and serves as authorized representative for Medicaid and/or Food Assistance when possible.
• Assists clients through Medicaid and/or Food Assistance redetermination process via tracking, meeting attendance, and completion of redetermination.
• Provides follow-up to confirm establishment of benefits.
• Conducts patient interviews and completes sliding-fee discount applications for those who do not qualify for public benefits.
• Monitors the volume of patients on sliding fee discount program and tracks hardship requests for those facing barriers to accessing care.
• Provides outreach and education to raise awareness about the Marketplace and refers consumers to health insurance ombudsman and consumer assistance programs.
• Conducts public education activities to raise awareness about coverage options under Medicaid, CHIP, and the Marketplace.
• Provides referrals to health insurance consumer assistance or ombudsman programs to address consumer grievances or questions.
• Acts as the agency’s liaison with the Department of Human Services, ODJFS, and other service providers to assist clients with obtaining entitlements.
• Develops professional relationships with other service providers, especially agencies serving mentally ill individuals.
• Demonstrates sensitivity and responsiveness to clients’ ethnic, cultural, and developmental backgrounds.
• Assists case managers with entitlement-related needs and communicates on the current status of entitlements.
• Engages in accurate and timely record-keeping in the agency EMR.
• Provides assistance and consultation to staff regarding entitlement questions.
• Attends continuing education trainings as directed by a supervisor.
• Performs other duties as assigned.

Requirements

• HS diploma or equivalent and related experience in working with entitlements.
• Demonstrated expertise in eligibility and enrollment rules and procedures.
• Training in the Marketplace and certification as a Certified Application Counselor for the current year open enrollment.
• Knowledge of qualified health plan options and insurance affordability programs.
• Valid Ohio driver’s license.
• Sensitivity in relating to persons of varying backgrounds and those who have experienced psychiatric problems.
• Ability to maintain confidentiality of sensitive information (written and/or verbal).
• Ability to work on multiple projects concurrently and handle a diversified workload.

Supports the organization’s mission, values, and goals, including initiative, teamwork, flexibility, and ethical interactions with staff and external parties. Adheres to federal and state laws, employment policies, and licensing/credentialing board standards.

Benefits

• Choice of medical and dental plans.
• Health Savings Account (HSA).
• Flexible Spending Account (FSA) for Health and Dependent Care.
• Vision coverage.
• Support for continuing education and credential renewal.
• Life Insurance.
• Retirement Savings (401k) with a company contribution.
• Mental Health Support.
• Employee Assistance Program (EAP).
• Calm Subscription.
• Short- and Long-Term Disability.