Benefits Specialist
The Centers
Job Title
Facilitates comprehensive linkage and follow-up between clients and staff, and the Cuyahoga County Department of Human Services, Social Security, the Marketplace, The Children's Health Insurance Program (CHIP) and other organizations that provide benefits.
Job Description
The responsibilities and duties of this position include, but are not limited to, researching client's current Medicaid status, working with the consumer to obtain and/or maintain their benefits and entitlements, coordinating the Medicaid application process, and collaborating with other members of a client's treatment team.
Job Qualifications
- HS diploma or equivalent and related experience in working with entitlements.
- Demonstrate and maintain expertise in eligibility and enrollment rules and procedures.
- Must have training in the Marketplace and have passed the test for Certified Application Counselors in preparation for the current year open enrollment.
- Know and understand the range of qualified health plan options and insurance affordability programs.
- Possess a valid Ohio driver's license.
- Supports the organization's overall mission and values including initiative, teamwork, and flexibility. Supports agency's philosophy, values and goals, and is conscientious about all organizational values. Is ethical in all interactions with the organization's staff and external parties.
- Adheres to the ethical, confidentiality, and professional standards of federal and state law, employment policies, and the policies of appropriate licensing and credentialing boards.
- Must have sensitivity in relating to persons of varying backgrounds and to those who have experienced psychiatric problems.
- Ability to maintain appropriate and required confidentiality ensuring the integrity of sensitive information (written and/or verbal).
- Ability to work on a variety of projects concurrently.
- Ability to handle a diversified workload.
Essential Job Duties and Responsibilities
- Provides clients with information and assistance regarding entitlements
- Explains eligibility.
- Assists clients with completing forms/applications/referrals and submits documentation.
- Works with clients to complete agency Financial Investigation process (FEE).
- Explains financial contract to clients.
- Verifies insurance coverage and obtains documentation of insurance coverage.
- Applies sliding fee when appropriate.
- Completes ADAMHS "Shares" program process including Diagnostic entry and UCI billing numbers, when appropriate.
- Actively works to ensure continued benefits for clients.
- When possible serves as authorized representative for Medicaid and/or Food Assistance on behalf of client.
- Assists client through Medicaid and or Food Assistance redetermination process through tracking, meeting attendance, and completion of redetermination process.
- 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 track hardship request for those who find co-pays and deductibles a barrier for accessing care.
- Provide outreach and education to raise awareness about the Marketplace and refer consumers to health insurance ombudsman and consumer assistance programs when necessary.
- Conduct public education activities to raise awareness about coverage options available under Medicaid, CHIP, and the Marketplace.
- Provide referrals to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the PHS Act to address consumer grievances, complaints, or questions about their health plan, coverage, or a determination.
- Acts as the agency's liaison with the Department of Human Services, ODJFS and/or other service providers that will assist clients with obtaining the entitlements. Develops professional relationships with other service providers, especially with other agencies that are providing services and/or entitlements to mentally ill individuals. Demonstrates a sensitivity and responsiveness to clients' ethnic, cultural, and development background.
- Assists case managers with any needs regarding entitlements; actively communicates on current status of entitlements.
- Engages in accurate and timely record keeping in agency EMR.
- Provides assistance and consultation to staff regarding entitlement questions.
- Attends continuing education trainings, as directed by their supervisor.
- Performs other duties as assigned.
About The Centers
The Centers through healing, teaching, and inspiring helps individuals and families to reach their full potential. We provide health, family, and workforce services at 11 locations throughout Greater Cleveland, creating life-changing solutions for people to lead healthier and more successful lives. We strive to be a service-oriented workplace that pioneers and co-creates solutions while fostering an inclusive community where our team members thrive.
At The Centers, meaningful work is grounded in a culture where people feel valued. As a 2026 USA TODAY Top Workplaces winner, the organization is nationally recognized, based entirely on employee feedback, for trust, purpose, and care. This position plays an important role in advancing our mission and supporting the communities we serve.
Wellbeing and Benefits
Providing quality benefits to our staff is important to us. Just as important is our staff's well-being. That's why we offer a number of choices from medical to dental to vision plans to meet the different needs of our staff.
- Choice of medical and dental plans
- Health Savings Account
- Flexible Spending Account for Health and Dependent Care
- Vision
- Support for continuing education and credential renewal
- Life Insurance
- Retirement Savings (401k) with a company contribution
- Mental Health Support
- Employee Assistance Program
- Calm Subscription
- Short and Long-term Disability
The Centers is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status, or any other characteristic protected by law.
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