Benefits Specialist

Benefits Specialist Graici | Full-Time | Fully Remote (Ohio) Occasional travel Salary range: $60,00-$70,000 About Graici Graici’s Adaptive Data Wallet securely acquires, organizes, and activates the information people need to access care, social benefits, and other essential resources. By bringing together an individual’s healthcare, social, employment, education, and financial information in a consent-based source of truth, Graici helps reduce administrative burden and make complex systems easier to navigate. The platform supports individuals and organizations across healthcare, public benefits, education, government, and commercial settings. Graici’s work includes Medicaid renewals, benefits enrollment, care navigation, and other processes that help people access the services and resources they need. The Role Graici is seeking a Benefits Specialist to provide direct support for individuals navigating Medicaid, Medicare, and related public-benefit processes. The primary focus of this role is Ohio Medicaid applications, renewals, redeterminations, documentation, notices, submissions, and agency follow-up. The role may also support Medicare and other social-benefit programs. The Benefits Specialist will help move cases forward, communicate with county and state agencies, track documentation and deadlines, identify risks, and support accurate and timely completion of applications and renewals. Where appropriate and permitted, this role may perform Authorized Representative responsibilities on behalf of Graici. This role may support both direct-to-consumer cases and partner-based benefits workflows. It focuses on direct benefits work and case progression. Client implementation, partner account management, workflow measurement, time studies, and operational savings analysis are owned by the Client Success team. The Benefits Specialist sits within Customer Success, reports to the Director of Customer Success, and works closely with Client Success, Product, Operations, and partner teams. What You’ll Own Ohio Medicaid and benefits case support Support Ohio Medicaid applications, renewals, redeterminations, and related submissions. Review Ohio Medicaid notices, documentation requests, deadlines, eligibility information, and outstanding requirements. Help individuals understand next steps and gather the information needed to complete or maintain coverage. Review application and renewal materials for completeness, accuracy, and consistency. Identify missing documentation, incomplete information, conflicting details, and other issues affecting case progress. Maintain accurate case records involving consent, documentation, status, deadlines, agency communication, and outcomes. Work within approved permissions, procedures, and consent requirements. Recognize that eligibility and benefit determinations remain with the appropriate government agency. Medicare and related benefits support Support Medicare-related benefits questions, documentation, enrollment, and follow-up when applicable. Communicate with appropriate Medicare agencies, plans, or representatives when applicable. Help individuals understand how Medicaid, Medicare, and other benefit programs may relate to their coverage and next steps. Identify cases involving Medicaid, Medicare, SNAP, or other benefits that require additional review. Support related public-benefit processes as assigned and within approved procedures. Authorized Representative responsibilities Perform Authorized Representative responsibilities when Graici has the appropriate designation, consent, and authority. Prepare and support the submission of applications, renewals, redeterminations, documentation, and related materials. Receive, review, and respond to notices and requests for additional information. Track cases through submission, agency review, additional-information requests, determinations, and closure. Maintain documentation of representative activity, communications, decisions, and required follow-up. Communicate with individuals, partner staff, county agencies, state agencies, and other authorized contacts as appropriate. Follow approved procedures for handling sensitive information and member documentation. Agency communication and escalation Communicate with county and state agencies regarding Ohio Medicaid applications, renewals, redeterminations, and related cases. Clarify requirements, submission status, outstanding documentation, determinations, and next steps. Identify when additional information, correction, clarification, or escalation is needed. Understand the factors, documentation, and circumstances that may support approval, trigger an additional-information request, or contribute to a denial or interruption in coverage. Escalate unresolved, complex, or time-sensitive cases appropriately. Document agency communication, decisions, next steps, and unresolved issues clearly. Maintain follow-up until the case is resolved, transferred, or otherwise closed. Case tracking and quality Track case status, deadlines, outstanding items, barriers, escalations, submissions, and outcomes. Monitor completion of applications, renewals, documentation requests, submissions, and follow-up activities. Identify cases at risk of delay, denial, or interruption in coverage. Review work for accuracy, completeness, consistency, and adherence to approved procedures. Maintain clear documentation of handoffs, decisions, follow-up, and case outcomes. Prepare case updates and benefits-related reports for Customer Success leadership. Identify recurring issues that affect case completion, timeliness, or quality. Support quality metrics related to accuracy, completion, timeliness, and resolution. Direct-to-consumer and partner support Support individuals directly through benefits-related processes when Graici is assisting them through a direct-to-consumer workflow. Work with partner staff when benefits support is delivered through an FQHC, healthcare organization, government program, or other partner. Provide clear guidance on required documents, deadlines, notices, and next steps. Help ensure that individuals and partner staff understand what information or action is needed. Maintain appropriate boundaries between benefits support, eligibility determination, and partner implementation responsibilities. Coordinate with the Client Success Specialist when a case issue affects partner workflow, training, implementation, or adoption. Escalate partner-level workflow concerns to the Client Success Specialist rather than assuming ownership of implementation or account management. Workflow and training support Translate benefits knowledge into clear, repeatable case-support workflows. Help create reference materials and training resources for future Benefits Specialists. Identify recurring documentation barriers, agency delays, process gaps, and case-resolution issues. Provide practical feedback to Product, Operations, and Customer Success based on case experience. Support testing and improvement of Graici’s benefits tools and workflows. Help clarify benefits-related requirements for new or changing workflows. Contribute to procedures that support Ohio Medicaid, Medicare, and related benefits processes. Who You Are Direct, recent experience supporting Ohio Medicaid applications, eligibility, enrollment, renewals, redeterminations, or authorization processes. Comfortable working with Ohio Medicaid forms, notices, documentation, deadlines, and agency requirements. Able to communicate with Ohio county and state benefits agencies. Able to recognize incomplete cases, missing information, and risks affecting coverage. Comfortable supporting multiple cases, deadlines, documents, and follow-up responsibilities independently. Detail-oriented and reliable when working with sensitive information. Able to recognize patterns across cases and explain their operational significance. Clear, patient, and respectful when working with individuals navigating stressful or unfamiliar processes. Comfortable communicating with partner staff and internal teams while maintaining clear ownership of case-related work. Comfortable working in an early-stage environment where tools and workflows are evolving. Able to raise concerns, question unclear processes, and help improve benefits workflows. Able to balance empathy with accuracy, accountability, confidentiality, and adherence to approved procedures. Comfortable learning new systems and digital tools used to support casework. Direct experience with Ohio Medicaid is required. Experience with Medicaid programs in other states is welcome but is not required. Medicare experience is warmly welcomed and considered a strong plus, but it is not required. Additional experience with SNAP or other social-benefit programs is also welcome. Candidates do not need to live in Ohio. Technology Skills Comfort with: Ohio Medicaid eligibility, enrollment, renewal, or authorization systems Medicare or health-benefits systems, when applicable Case management, benefits-tracking, or case documentation systems Secure document collection and management tools Google Workspace, including Docs, Sheets, Gmail, and shared drives Spreadsheets and basic reporting tools Secure email and communication platforms Virtual meeting platforms The role may include approved AI-assisted workflows for information organization, document review, drafting, pattern recognition, and case reporting. Prior experience with AI tools is not required. Training will be provided on Graici’s approved tools and workflows. This role does not require access to Graici’s sales CRM or HubSpot. What Success Looks Like Ohio Medicaid applications, renewals, and related casework are handled accurately and on time. Medicare-related questions and follow-up are handled appropriately when applicable. Individuals receive clear guidance and understand what information or action is needed. Applications, renewals, and supporting documentation are complete, organized, and submitted appropriately. Agency communication is documented, followed through, and escalated when necessary. Cases at risk of delay, denial, or interruption are identified early. Case records clearly show status, deadlines, outstanding items, risks, handoffs, and outcomes. Authorized Representative responsibilities are performed within approved permissions and procedures. Recurring documentation gaps and case-resolution barriers are identified and communicated. Benefits-related feedback helps improve Graici’s tools, workflows, and training materials. Future Benefits Specialists can use the processes and resources established through this role. Client Success has the benefits expertise needed to support accurate implementation and partner communication without the Benefits Specialist owning account management or implementation planning. Reporting and Collaboration This is a cross-functional role within Customer Success. The Benefits Specialist reports to the Director of Customer Success and works closely with Client Success, Product, Operations, and partner teams. The Client Success Specialist owns partner implementation, relationship management, workflow coordination, time studies, and operational measurement. The Benefits Specialist owns direct benefits support, case progression, agency communication, documentation, and benefits-related quality. This position is remote within Ohio, with occasional travel to partner sites or other locations as needed. Frequent partner interaction and periodic on-site implementation support may be required. #J-18808-Ljbffr Graici