Benefit Specialist

Wesley Health Centers - JWCH Institute, Inc.; Los Angeles (CA); On-site; USD 52,000 - 78,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Health Savings Account (HSA)

Paid time off

13 paid holidays

401(k) Safe Harbor/Profit Sharing

Mileage reimbursement

Disability insurance (LTD/STD)

Life insurance

Job summary

JWCH Institute, Inc. is seeking a Benefits Specialist to assist clients in accessing and maintaining health and social service benefits, including CalFresh, Medi-Cal, Medicare, and Ryan White programs.

You will guide eligibility, enrollment, renewals, and related processes while maintaining HIPAA-compliant records. The role requires strong communication and organizational skills, experience with health benefits, and the ability to work with high‑risk populations.

Qualifications

• Experience working with individuals affected by HIV/AIDS or in related healthcare/social services.
• 2–3 years in benefits enrollment, eligibility determination, or health insurance navigation preferred.
• HIV 101 and Basic HIV-Test Counselor Certification preferred, but not required.
• Experience with high‑risk populations such as MSM, homeless, transgender, POC, SUD, MH.
• Strong verbal and written communication skills; ability to explain complex benefits clearly.
• Valid CA Driver’s License; clean driving record.

Responsibilities

• Assist clients with applying for, accessing, and maintaining public and private benefits and entitlement programs (CalFresh, Medi‑Cal/Medicaid, Medicare, Social Security, WIC, Ryan White).
• Document client referrals, linkages, and connections to services per requirements.
• Make reminder calls and outreach for enrollment deadlines and follow‑ups.
• Communicate with insurance carriers and agencies to resolve eligibility or enrollment issues.
• Review eligibility information and determine required documentation and renewals.
• Maintain HIPAA-compliant confidentiality and accurate case notes in systems.
• Assess transportation benefits eligibility (TAP cards, plan transportation services).
• Collaborate with internal teams to link clients to services promptly.
• Attend trainings and meetings on changes to benefits and enrollment processes.
• Document client activities and outcomes in e2LA and other systems.

Skills

Verbal communication

Written communication

Organizational skills

Time management

Problem-solving

MS Office

Driver's license

Tools

Microsoft Word

Excel

Outlook

Job description

Position Purpose

Under the direction of the Program Manager, the Benefits Specialist assists eligible clients with accessing, applying for, and maintaining public and private health and social service benefits. The Benefits Specialist provides education and guidance regarding available programs and assists clients in navigating eligibility, enrollment, renewal, and benefits‑related processes. Programs may include Ryan White and other applicable federal, state, and local benefit programs.

Principal Responsibilities

• Assists clients with applying for, accessing, and maintaining public and private benefits and entitlement programs for which they may be eligible. Programs may include CalFresh, Medi‑Cal/Medicaid, Medicare, Social Security, Women, Infants, and Children (WIC), Ryan White, and other applicable programs.
• Ensures appropriate and timely documentation of client referrals, linkages, and connections to services in accordance with program and organizational requirements.
• Conducts reminder calls and other outreach to clients regarding upcoming enrollment and re‑enrollment deadlines and assists with scheduling appointments or follow‑up activities as needed.
• Communicates with insurance carriers, government agencies, and benefit program representatives to assist in resolving eligibility, enrollment, coverage, and benefits‑related issues.
• Reviews client eligibility information through applicable portals and systems to determine required documentation and identify outstanding eligibility or renewal requirements.
• Handles confidential client information and documentation, including medical and financial records, in accordance with HIPAA, organizational policies, and applicable privacy and confidentiality requirements.
• Maintains accurate, timely, and complete documentation and case notes as required by applicable programs, funding sources, and organizational standards.
• Assists clients with transportation‑related needs by assessing eligibility for available transportation benefits, including TAP cards and transportation services coordinated through the client's health plan.
• Collaborates effectively with internal departments and service providers to facilitate appropriate and timely linkage to available services.
• Participates in training sessions, informational meetings, and educational opportunities related to changes in benefits, eligibility requirements, enrollment processes, and available resources to ensure information provided to clients remains current and accurate.
• Participates in enrollment and benefits‑related staff meetings, clinic staff meetings, and other meetings as assigned.
• Accurately documents client activities, services, and follow‑up in the e2LA system and other applicable electronic systems.
• Adheres to all organizational safety policies, procedures, and regulatory requirements to ensure a safe environment for patients, staff, and visitors.
• Participates in required safety and compliance trainings and applies learned practices in daily work activities.
• Identifies, reports, and helps mitigate unsafe conditions, incidents, or hazards in the workplace.
• Uses equipment, tools, and supplies safely and responsibly in accordance with organizational and regulatory standards.
• Maintains awareness of infection control, occupational health, and emergency preparedness procedures appropriate to the role.
• Participates in JWCH’s customer service training called AIDET on an annual basis.
• Demonstrates an understanding of AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank You) to apply in patient encounters or team discussions.
• Utilizes the AIDET communication framework to communicate with patients and team members in a manner that reduces patient anxiety, increases patient compliance, and improves clinical outcomes.
• Performs all other duties assigned.

Requirements

• Minimum of one (1) year of experience working with individuals affected by HIV/AIDS or in a related healthcare, social services, benefits, or community‑based setting.
• Two (2) to three (3) years of experience in benefits enrollment, eligibility determination, health insurance navigation, social services, or a related field preferred.
• HIV 101 and Basic HIV‑Test Counselor Certification preferred, but not required.
• Experience working with high‑risk populations such as MSM, homeless, transgender, POC, SUD, MH.
• Strong verbal and written communication skills, with the ability to explain complex benefits and eligibility information clearly and respectfully.
• Strong interpersonal, organizational, time‑management, and problem‑solving skills.
• Working knowledge of Microsoft Office Suite, including Word, Excel, and Outlook.
• Possesses a valid CA Driver’s License, maintains a clean driving record.

Employee Benefits

At JWCH Institute, Inc., we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes:

• Medical, Dental, Vision
• Monthly employer‑sponsored allowance for assistance with health premiums.
• Funded Health Savings Account (up to deductible) to assist with carrier‑approved medical expenses.
• Paid time off (vacation, sick leave) and 13 paid holidays.
• 401(k) Safe Harbor Profit Sharing plan.
• Mileage reimbursement.
• Short‑ and long‑term disability plans (LTD/STD).
• Life insurance policy & AD&DD, and more!

Equal Opportunity and Fair Chance Employer

JWCH Institute, Inc + Wesley Health Centers is an Equal Opportunity and Fair Chance Employer.