Benefits Specialist

Job Purpose:

The Case Manager Benefits Specialist provides services to Ryan White and MAI eligible clients to assist in accessing medical care and supportive services. The Benefits Specialist also focuses on assessing eligibility and entitlements and assisting clients in completing necessary processes to access those benefits.

Essential Job Functions including, but not limited to:

1. Satisfies Core Competencies

• Accepts responsibility for ensuring that performance meets the standards of the professional, ethical, and relevant legislated requirements.
• Adheres to the Ryan White Standards of Care and agency policies in the provision of services to clients.
• Demonstrates cultural competency and commitment to patients.

1. Benefits Enrollment

• Remain knowledgeable of benefits and entitlements that population served may be eligible for by attending trainings, reviewing websites, reviewing applications, and maintaining relationships with various agencies and their relevant staff.
• Maintain working relationship with referral sources. Educate referral sources and clients on eligibility criteria, referral processes, and ensure availability of updated referral forms.
• Follow up with referrals in a timely matter making a minimum of three attempts to contact all referred clients. Accept walk-ins for assistance in urgent situations.
• Screen and interview all referred clients for eligibility.
• Assist clients in understanding and accessing benefits and entitlements that the clients may be eligible for including Social Security Benefits including Social Security Income (SSI), Social Security Disability (SSDI), and Low Income Subsidies; health insurance benefits including Medicaid, Medicare, ACA Marketplace health insurance policies, private insurance policies, and Cobra policies; Economic Stability applications including Financial Independence Temporary Assistance Program (FITAP), Supplemental Nutrition Assistance Program (SNAP), and Kinship Care Subsidy Program (KCSP); and LA HAP applications including uninsured Louisiana Drug Assistance Program (LDAP) and Health Insurance Program (HIP).
• Assist with completing OHCC LA HAP applications.
• Manage all OHCC patients with Health Insurance Premiums to ensure no one loses insurance coverage.
• Respect clients' right to make informed decisions about which programs clients will complete applications for within confines of the law. Educate clients on penalties and potential consequences for providing false information.
• Identify, compile, and review all necessary documentation relevant to applicants' application.
• Attend appointments and hearings relevant for clients' compliance in applying for benefits.
• Follow up with clients as appropriate to obtain necessary information to complete and supplement application as need arises and inquire about approval or denials that may have been received by the client. Provide expected time frames within which clients may expect to receive a decision based on available knowledge.

1. Other Duties

• Maintain patient confidentiality and comply with all federal and state health information privacy laws.
• Participate in ongoing quality improvement objectives.
• Resolve or address client requests within a timely manner.

1. Reporting and Program/Staff Development

• Document all services and contact in the client record.
• Attend all mandatory meetings and trainings assigned by supervisor.
• Collaborates with team members and leadership in reviewing program and departmental policies and procedures annually and amend as needed.
• Complete 16 hours of HIV orientation training and 24 hours of annual training.
• Maintains CEs as required by applicable licensing body.

Required Education:

• A bachelor's (required) or master's degree (preferred) in social work from a program accredited by the Louisiana State Board of Social Work Examiners; OR
• A bachelor's (required) or master's degree (preferred) in nursing (RN) currently licensed in Louisiana by the Board of Nurse Examiners (one year of paid experience will substitute for the degree); OR
• One (1) year of paid post-degree experience in direct service to target population.

Skills, Licensure and Knowledge Requirements:

• Current Basic Life Support (BLS) Certification required

Physical Demands:

The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach
• Specific vision abilities required include close vision requirements due to computer work
• Light to moderate lifting is required

Work Environment:

The work environment characteristics described here are representative of those the employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Moderate noise (i.e. business office with computers, phone, and printers, light traffic).
• Ability to work in a confined area.
• Ability to sit at a computer terminal for an extended period

Travel or Special Requirements:

Driving during the workday as well as local or out of state travel may be required to perform job duties.