Benefits Specialist; Outreach & Enrollment

The Centers; Cleveland (OH); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

401k with company contribution

Mental Health Support

Calm Subscription

Job summary

The Centers in Cleveland, OH seeks a qualified Eligibility Counselor to help clients access Medicaid, CHIP, and marketplace benefits by coordinating with DHS, Social Security, and health plans.

You will research Medicaid status, assist with applications, track redetermination, and support a care team while upholding confidentiality and ethical standards.

Qualifications

• HS diploma or equivalent and related experience in working with entitlements.
• Must have training in the Marketplace and have passed the test for Certified Application Counselors in preparation for the current year open enrollment.
• Know and understand the range of qualified health plan options and insurance affordability programs.
• Possess a valid Ohio driver’s license.
• Supports the organization’s mission, values, and ethics in interactions.
• Adheres to confidentiality and professional standards under federal/state law and agency policies.
• Sensitivity in relating to persons of varying backgrounds and those who have experienced psychiatric problems.
• Ability to maintain confidentiality and manage multiple projects concurrently.

Responsibilities

• Provides clients with information and assistance regarding entitlements.
• Explains eligibility and assists clients with completing forms/applications/referrals and submits documentation.
• Works with clients to complete the agency Financial Investigation process (FEE).
• Actively ensures continued benefits for clients and may act as authorized representative for Medicaid/food assistance.
• Conducts patient interviews and sliding-fee discount applications for those who do not qualify for public benefits.
• Provide outreach and education about the Marketplace and refer consumers to health insurance ombudsman and consumer assistance programs.
• Conduct public education activities to raise awareness about Medicaid, CHIP, and the Marketplace.
• Provide referrals to health insurance consumer assistance or ombudsman programs.
• Acts as liaison with DHS, ODJFS and other service providers to obtain entitlements.
• Assists case managers with entitlements and communicates current status to staff.
• Maintains accurate EMR records and attends continuing education trainings.

Job description

At The Centers, meaningful work is grounded in a culture where people feel valued. As a 2026 USA TODAY Top Workplaces winner, the organization is nationally recognized, based entirely on employee feedback, for trust, purpose, and care. This position plays an important role in advancing our mission and supporting the communities we serve.

Job Summary

Facilitates comprehensive linkage and follow-up between clients and staff, and the Cuyahoga County Department of Human Services, Social Security, the Marketplace, The Children’s Health Insurance Program (CHIP) and other organizations that provide benefits. The responsibilities and duties of this position include, but are not limited to, researching client’s current Medicaid status, working with the consumer to obtain and/or maintain their benefits and entitlements, coordinating the Medicaid application process, and collaborating with other members of a client’s treatment team.

Job Qualifications

• HS diploma or equivalent and related experience in working with entitlements.
• Demonstrate and maintain expertise in eligibility and enrollment rules and procedures.
• Must have training in the Marketplace and have passed the test for Certified Application Counselors in preparation for the current year open enrollment.
• Know and understand the range of qualified health plan options and insurance affordability programs.
• Possess a valid Ohio driver’s license.
• Supports the organization’s overall mission and values including initiative, teamwork, and flexibility. Supports agency’s philosophy, values and goals, and is conscientious about all organizational values. Is ethical in all interactions with the organization’s staff and external parties
• Adheres to the ethical, confidentiality, and professional standards of federal and state law, employment policies, and the policies of appropriate licensing and credentialing boards.
• Must have sensitivity in relating to persons of varying backgrounds and to those who have experienced psychiatric problems.
• Ability to maintain appropriate and required confidentiality ensuring the integrity of sensitive information (written and/or verbal).
• Ability to work on a variety of projects concurrently.
• Ability to handle a diversified workload.

Essential Job Duties and Responsibilities

• Provides clients with information and assistance regarding entitlements
  • Explains eligibility.
  • Assists clients with completing forms/applications/referrals and submits documentation.
• Works with clients to complete agency Financial Investigation process (FEE).
  • Explains financial contract to clients.
  • Verifies insurance coverage and obtains documentation of insurance coverage.
  • Applies sliding fee when appropriate.
  • Completes ADAMHS “Shares” program process including Diagnostic entry and UCI billing numbers, when appropriate.
• Actively works to ensure continued benefits for clients.
  • When possible serves as authorized representative for Medicaid and/or Food Assistance on behalf of client.
  • Assists client through Medicaid and or Food Assistance redetermination process through tracking, meeting attendance, and completion of redetermination process.
  • Provides follow up to confirm establishment of benefits.
• Conducts patient interviews and completes sliding-fee discount applications for those who do not qualify for public benefits. Monitors the volume of patients on sliding fee discount program and track hardship request for those who find co-pays and deductibles a barrier for accessing care.
• Provide outreach and education to raise awareness about the Marketplace and refer consumers to health insurance ombudsman and consumer assistance programs when necessary.
• Conduct public education activities to raise awareness about coverage options available under Medicaid, CHIP, and the Marketplace.
• Provide referrals to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the PHS Act to address consumer grievances, complaints, or questions about their health plan, coverage, or a determination.

• Acts as the agency’s liaison with the Department of Human Services, ODJFS and/or other service providers that will assist clients with obtaining the entitlements. Develops professional relationships with other service providers, especially with other agencies that are providing services and/or entitlements to mentally ill individuals. Demonstrates a sensitivity and responsiveness to clients’ ethnic, cultural, and development background.

• Assists case managers with any needs regarding entitlements; actively communicates on current status of entitlements.
• Engages in accurate and timely record keeping in agency EMR.
• Provides assistance and consultation to staff regarding entitlement questions.
• Attends continuing education trainings, as directed by their supervisor.

• Performs other duties as assigned.

Wellbeing and Benefits

Providing quality benefits to our staff is important to us. Just as important is our staff’s well-being. That’s why we offer a number of choices from medical to dental to vision plans to meet the different needs of our staff.

Choice of medical and dental plans

• Health Savings Account
• Flexible Spending Account for Health and Dependent Care
• Vision
• Support for continuing education and credential renewal
• Life Insurance
• Retirement Savings (401k) with a company contribution
• Mental Health Support
• Employee Assistance Program
• Calm Subscription
• Short and Longterm Disability