Benefit Specialist

Job Description

Job Description

Position Purpose:

Under the direction of the Program Manager, the Benefits Specialist assists eligible clients with accessing, applying for, and maintaining public and private health and social service benefits. The Benefits Specialist provides education and guidance regarding available programs and assists clients in navigating eligibility, enrollment, renewal, and benefits-related processes. Programs may include Ryan White and other applicable federal, state, and local benefit programs.

Principal Responsibilities:

1. Assists clients with applying for, accessing, and maintaining public and private benefits and entitlement programs for which they may be eligible. Programs may include CalFresh, Medi-Cal/Medicaid, Medicare, Social Security, Women, Infants, and Children (WIC), Ryan White, and other applicable programs.
2. Ensures appropriate and timely documentation of client referrals, linkages, and connections to services in accordance with program and organizational requirements.
3. Conducts reminder calls and other outreach to clients regarding upcoming enrollment and re-enrollment deadlines and assists with scheduling appointments or follow-up activities as needed.
4. Communicates with insurance carriers, government agencies, and benefit program representatives to assist in resolving eligibility, enrollment, coverage, and benefits-related issues.
5. Reviews client eligibility information through applicable portals and systems to determine required documentation and identify outstanding eligibility or renewal requirements.
6. Handles confidential client information and documentation, including medical and financial records, in accordance with HIPAA, organizational policies, and applicable privacy and confidentiality requirements.
7. Maintains accurate, timely, and complete documentation and case notes as required by applicable programs, funding sources, and organizational standards.
8. Assists clients with transportation-related needs by assessing eligibility for available transportation benefits, including TAP cards and transportation services coordinated through the client's health plan.
9. Collaborates effectively with internal departments and service providers to facilitate appropriate and timely linkage to available services.
10. Participates in training sessions, informational meetings, and educational opportunities related to changes in benefits, eligibility requirements, enrollment processes, and available resources to ensure information provided to clients remains current and accurate.
11. Participates in enrollment and benefits-related staff meetings, clinic staff meetings, and other meetings as assigned.
12. Accurately documents client activities, services, and follow-up in the e2LA system and other applicable electronic systems.
13. Adhere to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.
14. Participate in required safety and compliance trainings and apply learned practices in daily work activities.
15. Identify, report, and help mitigate unsafe conditions, incidents, or hazards in the workplace.
16. Use equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.
17. Maintain awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.
18. Participate in JWCH’s customer service training called AIDET on an annual basis.
    1. Demonstrate an understanding of AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank You) to apply in patient encounters or team discussions.
    2. Utilize the AIDET communication framework to communicate with patients and team members in a manner that reduces patient anxiety, increases patient compliance, and improves clinical outcomes.
19. Perform all other duties assigned.

Requirements:

1. Minimum of one (1) year of experience working with individuals affected by HIV/AIDS or in a related healthcare, social services, benefits, or community-based setting.

2. Two (2) to three (3) years of experience in benefits enrollment, eligibility determination, health insurance navigation, social services, or a related field preferred.

3. HIV 101 and Basic HIV-Test Counselor Certification preferred, but not required.

4. Experience working with high-risk populations such as MSM, homeless, transgender, POC, SUD, MH.

5. Strong verbal and written communication skills, with the ability to explain complex benefits and eligibility information clearly and respectfully.

6. Strong interpersonal, organizational, time-management, and problem-solving skills.

7. Working knowledge of Microsoft Office Suite, including Word, Excel, and Outlook.

8. Possess a valid CA Driver’s License, maintain a clean driving record.

Employee Benefits:

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes:

• Medical, Dental, Vision
• Monthly employer-sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier-approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short- and long-term disability plans (LTD/STD).
• Life insurance policy & AD&D, and more!

Become part of a team where your work matters. Apply today and help us change lives, one patient at a time.

JWCH Institute, Inc + Wesley Health Centers  is an Equal Opportunity and Fair Chance Employer.