Benefits Specialist - Contract

Macomb County Community Mental Health; Clinton Charter Township (MI); On-site; USD 38,000 - 48,000; Full time

Job summary

Macomb County Community Mental Health in Michigan is seeking an MI Bridges Navigator to help persons served obtain Medicaid benefits, review costs and funding options, and assist with applications and follow-up for services funding.

You will coordinate with DFA workers, validate insurance with Medicare and other payers, and educate clients on options and next steps while maintaining confidential records within MCCMH.

Qualifications

• Associate degree in accounting, business, finance or related field.
• Minimum 2 years in revenue collection, medical coding, medical billing or related field.
• Minimum 1 year or more experience helping beneficiaries obtain benefits.

Responsibilities

• Assist person served with MI Bridges/Navigator tasks to obtain Medicaid benefits.
• Review services costs and funding options and help access funding for services.
• Ensure person served maintains Medicaid and insurance coverage; assist with applications and documentation.

Skills

Collaborative

Accountable

Respectful

English proficiency

Independent work

Education

Associate degree in accounting/Business/Finance

2+ years revenue/medical billing experience

1+ year working with beneficiaries to obtain benefits

Tools

Peter Chang EMR (PCE)

Job description

Under direction, complete the initial person served registration process, review services costs and funding options, ensure accurate person served insurance information, and assist with accessing funding options for services. Provide direct support in the completion, submission, and follow-up needed for person served to access services funding. Ensures the person served maintains benefits, including Medicaid. Performs other duties as assigned.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Work as an MI Bridges Navigator to help persons served obtain Medicaid benefits.

Coordinate with MDDHS DFA worker to streamline and process Medicaid applications.

Validate insurance with Medicare and commercial payers.

Work with persons served to complete income determination documentation into the EMR.

Educate persons served related to options, expected costs, and navigate the next steps in obtaining services through MCCMH.

Collaborate with case managers or other clinical team members to inform them of upcoming Medicaid redeterminations and terminations.

Submit/track Medicaid deductible information/documentation through MDHHS.

Identify and register persons served for non-Medicaid waiting lists

QUALIFICATIONS

Required Education and Experience

• An associate’s degree in accounting, Business Administration, Finance, or a directly related field from an accredited college or university is required
• A minimum of two (2) years of experience working in revenue collection, medical coding, medical billing, or a related field
• A minimum of one (1) or more years of experience working with beneficiaries to obtain benefits.

Preferred Education and Experience

• Experience with an electronic medical record system from Peter Chang Enterprises (PCE)
• Experience with a Community Mental Health Services Program (CMHSP) or Prepaid Inpatient Health Plan (PIHP)
• Previous work helping persons served navigate complex benefit applications and processes

Required Licenses or Certifications

• MI Bridges Navigator certification (or ability to obtain immediately upon hire)
• Possession of a valid Michigan driver's license and operable, insured automobile for authorized travel

Preferred Licenses or Certifications

• None

COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES

Knowledge of:

• Knowledge of applicable computer applications.
• Knowledge of billing practices for Medicaid, Healthy Michigan, and other funding sources.
• Knowledge of third-party insurance procedures and requirements.
• Knowledge of Medicare insurance procedures and requirements.
• Knowledge of the Michigan Mental Health Code and provided services.
• Knowledge of financial information on person served resources.
• Knowledge of credit collection laws and procedures.
• Knowledge of what constitutes legal liability.

Skill in:

• Using good professional judgment and initiative.

Ability to:

• Collaborative: Approaches all situations with teamwork and a solution-focused mindset, demonstrated through active participation in meetings, volunteering to assist teammates and other departments as appropriate. Examples include participation in internal and external committees, subcommittees, process-improvement groups, and other multi-organizational initiatives.
• Accountable: Takes ownership and empowers others to do the same, as evidenced by identifying solutions and acting on job responsibilities and organizational objectives daily.
• Respectful: Treats people with dignity while honoring individual differences demonstrated through use of positive and encouraging statements and/or interactions to, about, and/or with colleagues and persons served; evidenced by supervisor observation, feedback from other department staff, and leadership.
• Effectively speak, write, and understand English.
• Effectively speaking, writing, and understanding a language other than English is preferred.
• Understand and carry out oral and/or written instructions.
• Accurately organize and maintain paper documents and electronic files.
• Maintain the confidentiality of information.
• Work independently

Complies with P.A. 390, as amended, known as the State’s Emergency Management Act and the County’s Emergency Management resolution as well as all related plans, policies and procedures covered by those statutes.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by employees in this job. Employees may be requested to perform job-related tasks other than those specifically presented in this description.

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment amongst other possible accommodations.

GRANT OR EXTERNALLY FUNDED POSITION –

This position will continue only if sufficient grant or external funds are provided.