Eligibility Specialist

PECAN VALLEY MH-MR REGION•Weatherford, TX

2d•$15 - $15

About The Position

Under the supervision of the Clinic Manager, job functions center around assessing and verifying funding sources for individuals to assist Pecan Valley Centers in maximizing resources for funding. Various state systems for review of benefits will be utilized for daily tasks. Works with case managers to ensure financial information is current and correct for existing individuals enrolled in services and making referrals as necessary. Works with billing department to correct billing errors related to payer sources and to ensure correct funding sources are identified. Completes updated financial assessments on current individuals annually or as needed. Completes initial consents and demographic information for individuals as needed. Services may be provided in person or via telehealth as needed. Assess individuals requesting services or who have been determined eligible for services to determine their ability to pay. Complete client benefit screenings to determine eligibility for third party benefits (Medicaid, Medicare etc.) or to make application for disability as well as Medicare Part D plans for pharmaceutical benefits. Interact positively with service providers, both internally and externally, when completing assessments or making referrals. Utilize internal reports to monitor expiration dates for financial assessments and funding sources changes/re-certification. Professionally communicate with funding agencies’ representatives to complete authorization processes for individual services. Complete reports and screenings clearly, concisely, and promptly document in internal electronic health record. Exhibit flexibility, independence and organizational skills to work efficiently. Must be familiar with, and/or willing to be trained in, trauma-informed care. This includes understanding, recognizing, and responding to the effects of all types of trauma, and an ability to work in an environment where staff convey dignity, respect, hopefulness, and the opportunity for choice and empowerment among consumers.

Requirements

High School diploma or GED required.
Must have computer operating skills and capability of learning new computer operating systems.
Must be familiar with, and/or willing to be trained in, trauma-informed care. This includes understanding, recognizing, and responding to the effects of all types of trauma, and an ability to work in an environment where staff convey dignity, respect, hopefulness, and the opportunity for choice and empowerment among consumers.
Must be able to bend, stoop, kneel, crouch, squat, lift at least 25 pounds, reach overhead, sit for an extended period of time, and walk over a variety of terrains.

Nice To Haves

Some college work preferred.
Knowledge of the social security system or third-party payers highly preferred.
Experience working with individuals with developmental disabilities or mental health conditions.
Bilingual (English/Spanish) preferred.

Responsibilities

Assessing and verifying funding sources for individuals
Utilizing state systems for review of benefits
Working with case managers to ensure financial information is current and correct
Working with the billing department to correct billing errors related to payer sources
Completing updated financial assessments
Completing initial consents and demographic information
Assessing individuals to determine their ability to pay
Completing client benefit screenings to determine eligibility for third party benefits
Making applications for disability and Medicare Part D plans
Interacting positively with service providers
Utilizing internal reports to monitor expiration dates for financial assessments and funding sources changes/re-certification
Professionally communicating with funding agencies’ representatives to complete authorization processes
Completing reports and screenings clearly, concisely, and promptly documenting in internal electronic health record
Exhibiting flexibility, independence, and organizational skills to work efficiently