Eligibility Specialist

PECAN VALLEY MH-MR REGION•Granbury, TX

18h•$15 - $15

About The Position

Under the supervision of the Clinic Manager, the Eligibility Specialist assesses and verifies funding sources to help Pecan Valley Centers maximize resources for funding. The role uses various state systems to review benefits and works with case managers to keep financial information current and correct for individuals enrolled in services, making referrals as needed. The specialist also works with the billing department to address payer-source billing errors and ensure the correct funding sources are identified. The position completes initial consents and demographic information as needed, as well as updated financial assessments annually or when needed. Services may be provided in person or via telehealth. The specialist assesses individuals requesting or determined eligible for services to establish their ability to pay; screens for eligibility for third-party benefits such as Medicaid and Medicare; and may help individuals apply for disability benefits and Medicare Part D pharmaceutical benefits. The role also monitors assessment and funding-source expiration or recertification dates, communicates with funding-agency representatives about service authorizations, and documents reports and screenings in the internal electronic health record. The specialist is expected to work flexibly, independently, and with strong organizational skills. They must be familiar with trauma-informed care or willing to be trained in it, including understanding and responding to the effects of trauma and supporting an environment of dignity, respect, hope, choice, and empowerment.

Requirements

High school diploma or GED required.
Experience working with individuals with developmental disabilities or mental health conditions.
Computer operating skills and the ability to learn new computer operating systems.
Familiarity with trauma-informed care or willingness to be trained in it.
Ability to bend, stoop, kneel, crouch, squat, lift at least 25 pounds, reach overhead, sit for an extended period, 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.
Bilingual in English and Spanish preferred.

Responsibilities

Assess and verify funding sources to help maximize resources for funding.
Use state systems to review individuals’ benefits.
Work with case managers to keep financial information current and correct and make referrals as necessary.
Work with the billing department to correct payer-source billing errors and identify correct funding sources.
Complete updated financial assessments annually or as needed.
Complete initial consents and demographic information as needed.
Assess individuals’ ability to pay for services.
Screen individuals for eligibility for third-party benefits, including Medicaid and Medicare, and assist with applications for disability benefits and Medicare Part D plans as applicable.
Interact positively with internal and external service providers when completing assessments or making referrals.
Use internal reports to monitor financial-assessment expiration dates and funding-source changes or recertification.
Communicate professionally with funding-agency representatives to complete service authorization processes.
Complete reports and screenings clearly, concisely, and promptly, and document them in the internal electronic health record.
Provide services in person or via telehealth as needed.
Apply trauma-informed care principles and support consumers’ dignity, respect, hope, choice, and empowerment.