Patient Benefit Specialist
: Job Details :

Description Pay is determined by relevant experience, work history, education and internal equities. As part of our Diversity, Equity, and Inclusion practices, MHMR offers the maximum compensation for candidates based on their experience, education and internal equities of the agency. This practice removes biases in compensation and assist hires and/or promotions on pay equity in their appropriate position(s) at MHMR.I) Job PurposeUnder the direction from PBS Management Team, this position performs a variety of functions based on the agency's changing needs. The PBS team's primary duty is to establish and maintain an individual's access to relevant benefits. This includes: (1) Completion of annual registrations/fee assessments and agency consent forms. (2) Locating and facilitating of alternate funding sources to pay for medication (Patient Assistance Program (PAP), Medicare Part D Drug Plan (PDP), Medicaid Plans, and Adjudication Control). PBS will act as a resource for benefits information to the staff and individuals we serve to assist in providing care coordination activity opportunities. PBS staff strive to ensure impactful services are the right services, at the right time and right place, as members of the care coordination team. The position also requires basic knowledge of software and data system programs.II) Essential FunctionsA) Contribute to the development of eligibility screening tools for various benefits.B) Screen and refer individuals for benefits such as SSI/Medicaid, SSDI/Medicare, Medicaid Plans, QMB, SLMB, MQMB, Healthcare Marketplace, SNAP, Lifeline Cell Phone Service, and JPS Connection Applications.C) Conduct trauma-informed interviews to determine eligibility for agency purchase of prescribed medication.D) Initiate applications to the Patient Assistance Program (PAP) and other programs.E) Monitor Med Data portal for PAP medication status.F) Perform weekly inventory of on-site PAP medications with Medical Assistants.G) Research documentation in EHR and conduct trauma-informed interviews to assess ongoing eligibility.H) Request, review, and upload required paperwork, complete registrations/fee assessments, sign agency consent forms, update demographics, and update family status/household income.I) Provide information to individuals, meet key performance indicators, benchmarks, and quality measures.J) Participate in inter-agency coordination of Medicaid service programs in accordance with Random Moment in Time Study (RMTS), including involvement in program policy development.K) Conduct reminder calls for provider appointments related to upcoming fee assessment updates.L) Generate Face Sheets and Flow Sheets for provider appointments.M) Collect and process copayments/Monthly Max (MM)/deductibles from clients.N) Verify insurance and demographic information accuracy with clients before provider appointments and collect necessary documentation for reported changes.O) Keep Manager informed of changes, problems, and barriers as they arise.P) Performance standards are performed as applicable with MHMR's We CARE values We Connect People in Our Community. We Provide Access to Services. We Link People to Resources. We Empower People. Q) Performs other job duties or responsibilities as requested or assigned.III) Knowledge of Laws, Regulations, Policies/Procedures, Skills, and AbilitiesA) MHMRTC Policies and Procedures, Medicaid ProceduresB) Working knowledge of MHMRTC services and area resources for individuals with disabilities.C) Advanced language and communication skills (both written and verbal).D) Effective interpersonal skills, exemplary customer service skills, and professional conduct in all interactions with internal and external contacts.E) Demonstrates a high level of integrity and confidentiality.F) Effective organizational and time management skills, attention to detail, and the ability to work autonomously while keeping Manager informed of changes, problems, and barriers as they arrive.G) Required computer skills/abilities include daily data entry in approved agency computer systems including documenting every encounter and service rendered in EHR, documenting in Microsoft Office applications including Word and Excel, and frequent use of e-mail and instant messaging via Microsoft TeamsH) Ability to comply with agency dress code standards.IV) Internal & External Customer ServiceA) This position requires extensive internal (team member, agency personnel) and external customer service. The position will accomplish this with above average written and oral skills.B) Must demonstrate compassion, trauma-informed care, and safety practices including suicide safe careV) TravelA) Adhere to MHMR Mileage and Travel reimbursement policy and any other aspect regarding travel.B) Requires occasional overnight state-wide travel and may require ride sharing using personal and/or available company vehicle.C) Requires local travel in personal vehicle between MHMR Tarrant clinics as needed.D) May require temporary or permanent re-assignment to any of the clinics as determined by program needs.VI) Equipment UsedA) Utilized as required for position. Minimum Requirements VII) Minimum QualificationsA) Minimum Education: High School Diploma/GEDB) Defined Education: NoneC) Preferences: Bachelor's Degree in Health and Human Services, Business, or Finance; BilingualD) Substitutions: Bachelor's Degree and no prior work experienceE) Years' Experience: Four (4) yearsF) Defined Experience: Health and Human Services, Finance, Healthcare, Consumer BenefitsG) License/Certifications: Valid Texas Driver's LicenseH) Special Courses: NoneI) Supervisory Experience: NoneVIII) Agency RequirementsA) All staff are required to participate in agency Emergency Preparedness and Environmental Safety programs and may be assigned by their department as a key/essential staff level function during critical events or for the purpose of sustaining business continuity.B) This position may require temporary or permanent re-assignment to any MHMR Tarrant facility as determined by program needs and/or the Division/Director.C) Assigned work hours may change as the needs of the agency change.D) The Functional Title of this position may change as the needs of the agency change.E) All work will be completed within the scheduled work hours. All non-exempt (hourly) employees are expected to clock in and clock out for each work shift, no work should be done off the clock.F) MHMR reserves the right to change, add to or eliminate positions as it deems appropriate. G) Employment is at will, as well as agency needs may change.H) Agency dress code is to be followed at all times.I) Physical on-site presence, including regular attendance and punctuality, is an essential function of this position. Any changes or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.Lifting requirements 25-50#Our Benefits:All staff are required to participate in agency Emergency Preparedness and Environmental Safety programs and may be assigned by their departments as a key/essential staff level function during critical events or for the purpose of sustaining business continuity.This position may require temporary or permanent re-assignment to any MHMR Tarrant facility as determined by program needs and /or the Division/Director.Assigned work hours may change as the needs of the agency change.The functional Title of this position may change as the needs of the agency change.All work will be complete within the scheduled work hours. All non-exempt (hourly) employee are expected to clock In and out for each work shift, no work done should be done off the clock.Prior approval from supervisor is required for all Paid Time Off (PTO) and Overtime.MHMR reserves the tight to change, and to or eliminate a position as it deems appropriate.Employment is at will, as well as agency needs may change.Agency dress code is to be followed at all times.Physical on-site presence, including regular attendance and punctuality is an essential function of this position. Any change or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.Our Benefits:Our total rewards program offers benefits* to full time employees beginning 1st of the month following hire date including but not limited to:• Comprehensive healthcare options (Medical, Dental, and Vision)• Life insurance and additional supplemental accident and hospitalization plans• 401a match and 457 deferred compensation plans• Paid vacation and holidays; varied flexible work environment locations• Annual tuition reimbursement program• Student Loan Forgiveness• Professional development programs and training• And more.....Insurance eligibility:• Full time employees begin 1st of the month following hire date• Market driven positions (full time or part time) begin immediately after hire date• Select part time market driven positions are eligible for most insurance plans• Substitute status jobs are not eligible for benefitsFor more information, click Additional Information*MHMR of Tarrant County ( MHMR ) and its affiliates and subsidiaries have an internal recruiting department. MHMR may supplement that internal capability from time to time with assistance from temporary staffing agencies, placement services, and professional recruiters herein after referred to collectively as Recruiters ). Recruiters are hereby specifically directed NOT to contact MHMR employees directly in an attempt to present candidates - MHMR recruiting team or other authorized MHMR personnel must present ALL candidates to hiring managers. For more information please visit our website www.mhmrtc.org