Benefits Specialist

The Information Center, Inc.•Taylor, MI

About The Position

This role supports the Community Navigation Department by assisting individuals with applying and maintaining their Medicaid benefits for the MI Choice Medicaid Waiver program. The position is responsible for maintaining accurate records, applications and cases. The Benefits Specialist completes required updates on time and communicates with MDHHS to obtain and maintain Medicaid benefits. This role also assists with accessing food and healthcare benefits, and provides community education and outreach to reduce Medicare fraud, errors and abuse.

Requirements

Working knowledge of MDHHS benefits, application and redetermination processes.
Strong organizational skills and attention to detail.
Sound judgement and decision-making skills.
Strong critical thinking and analytical skills.
Ability to successfully manage several projects simultaneously.
Ability to work independently with minimal supervision and in a team environment.
Ability to collaborate with the Care Management Department and Community Navigation Department management and staff to identify and remediate issues related to benefit eligibility.
Ability to learn new software including but not limited to COMPASS, CHAMPS, Patient Ping, MI Health Plan Benefits, ACA Marketplace and MI Bridges.
Working knowledge of current HIPAA requirements as they relate to participant and program confidentiality.
Must possess a valid Michigan Driver’s License, current automobile insurance, and reliable transportation.
Experience with Medicaid application and redetermination processes including supporting documentation required.
Two years’ experience working in human services or healthcare successfully completing related duties required.

Nice To Haves

Bachelor's degree preferred.
SHIP counselor certification preferred.
MI Bridges and ACA Marketplace application and enrollment training preferred.

Responsibilities

Complete and review all benefit related documentation, primarily new Medicaid applications, Medicaid Redeterminations, and Food Assistance applications on behalf of MI Choice Medicaid Waiver participant’s and submit to MDHHS.
Act as a liaison with MDHHS for issues and concerns related to participants’ benefits and Medicaid eligibility.
Review, coordinate, prepare and submit annual redetermination documentation to MDHHS on behalf of MI Choice Waiver participants, including all income and asset verifications.
Request Medicaid Case Transfers from Local MDHHS offices to the Adult Medical District (AMD).
Archive Medicaid paperwork when MI Choice Medicaid Waiver cases close.
Archive closed Medicaid charts within the fiscal year and prepare them for off-site storage.
Submit timely and accurate MI Choice Medicaid Waiver participant enrollment and disenrollment information to be entered in the CHAMPS system.
Presents education on Medicare fraud, errors and abuse during outreach events as part of the Senior Medicare Patrol program.
Track and report Senior Medicare Patrol program individuals served, events and other relevant information.
Provide application and enrollment assistance for Affordable Care Act (ACA) Marketplace, MI Bridges programs and Medicare.
Back-up as needed for NFLOCD (Nursing Facility Level of Care Determination) entry in CHAMPS.
Back-up as needed for participant hospitalization notifications and status changes.
This job description is not intended to be all inclusive, and employee will also perform other reasonably related duties as assigned by immediate supervisor.