Benefits Specialist (51195)

POSITION SUMMARY:

Person in this position will be responsible for management of Outpatient Medi-Cal and 3rd party payment program including review of applications and verification of eligibility. Essential Job Functions include those listed below.

ESSENTIAL JOB FUNCTIONS:

• Determine financial eligibility of clients entering the program.
• Review all applications for short term assistance under Drug Medi-Cal or other health coverage.
• Determine applicable private pay fees through sliding scale process.
• Verify monthly Medi-Cal eligibility.
• Communicate with referral sources.
• Make recommendations on providing financial assistance.
• Provide direct information and services to agency clients regarding the availability of public assistance benefits and services, i.e., federal, state, county, and private agency assistance.
• Monitor and verify eligibility of Medi-Cal benefits for all programs.
• Documentation of eligibility, services provided and follow up activities monthly.
• Scheduling necessary appointments for clients to review documents, make determinations and monitor payments.
• Monitor expenditure of funds to ensure contract compliance.
• Must Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation; and
• Perform all other duties as assigned.

ESSENTIAL QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Experience and Competencies:

• Excellent computer skills.
• Excellent organizational skills.
• Excellent communication skills.
• Must be sensitive to populations served.
• Knowledge of substance abuse and treatment is desired.
• Excellent communication skills.
• Ability to exercise good judgment and discretion.
• Ability to work well in a team environment.
• Adherence to the highest standard of ethical conduct, especially to standards governing confidentiality.
• Professional appearance and demeanor
• Ability to obtain and maintain clearance from California Department of Corrections and Rehabilitation (CDCR).
• Ability to obtain and maintain clearance from LEIE, MSIL, and EPLS.
• Valid drivers license and ability to obtain and maintain WestCares vehicle insurance is required.
• Must be able to obtain and maintain Fresno County Credentialing.
• As mandated by the State of California those employees who work at Residential, Outpatient, Sober Living, provide Mental Health Services, Administrative Staff or Transitional Living Facilities must be fully vaccinated and have received a booster. Employees that have requested a Medical or Religious Exemption, which has been approved by Human Resources will be required to test for the virus weekly.
• During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with. Should this occur Human Resources or appropriate personnel will inform you.
• CPR Certification, First Aid Certification, and an annual Tuberculosis test.

EDUCATION and/or EXPERIENCE:

• One (1) years experience dealing with public assistance benefit programs or benefits i.e., TANF, food stamps, social security, VA pension, etc. (preferably in a non-profit organization).
• Graduation from an accredited four-year college with a degree in business, accounting, or another related field preferred.
• High School Diploma required.

LICENSURE/CERTIFICATION:

• Not applicable for this position.

WORKING CONDITIONS:

• Work is primarily performed in an office or in a residential/outpatient treatment setting.
• Some outdoor activities may be required.
• UA testing of clients is required.
• Must be able to de-escalate situations in the program.