Benefits Specialist

DescriptionPOSITION TITLE: Benefits Specialist

REPORTS TO: Manager of Health Information and Revenue Cycle, Director of Finance and Operations

DIRECT REPORTS: None

FLSA STATUS: Non-Exempt; Regular Full-Time; Employment-at-Will Position

SCHEDULE: Full-time, 40 hours per week, generally Monday through Friday during Kanza Mental Health & Guidance Center’s normal hours of operation. Schedule may vary based on client, program, and organizational needs.

WORK LOCATION: This position is primarily based at Kanza Mental Health & Guidance Center’s Hiawatha, Kansas office. The Benefits Specialist will be required to travel to Kanza’s Holton, Kansas office and other community locations as necessary to meet client and organizational needs.

PURPOSE:

The Benefits Specialist assists individuals receiving services from Kanza Mental Health & Guidance Center with identifying, applying for, maintaining, and understanding public benefits, financial assistance programs, health coverage, and community resources for which they may be eligible.

This position serves as an important resource for individuals who may experience barriers to accessing health care, behavioral health treatment, medication, housing, food, transportation, income, or other basic needs. The Benefits Specialist works directly with clients, families when appropriate, Kanza treatment teams, community agencies, government programs, and other organizations to help individuals successfully navigate complex benefit systems.

As a Certified Community Behavioral Health Clinic (CCBHC), Kanza is committed to providing comprehensive, coordinated, person-centered, family-centered, and recovery-oriented behavioral health services. The Benefits Specialist supports the CCBHC model by helping reduce social and financial barriers that may interfere with an individual’s ability to access or remain engaged in behavioral health and physical health services. The position works collaboratively with clinical staff, care coordinators, case managers, medical providers, peer support specialists, and community partners to promote continuity of care and connect individuals to appropriate health and social service resources.

ESSENTIAL JOB FUNCTIONS:

1. Benefits Screening and Assistance

Meet directly with clients to identify potential eligibility for federal, state, and local benefit programs and community resources.
Assist clients with understanding and navigating programs that may include:

Medicaid/KanCare;
Medicare;
Social Security Disability Insurance (SSDI);
Supplemental Security Income (SSI);
Supplemental Nutrition Assistance Program (SNAP);
Temporary Assistance for Needy Families (TANF);
Health insurance and health coverage programs;
Prescription medication assistance programs;
Housing and rental assistance programs;
Utility assistance;
Transportation resources;
Food and other basic-needs programs;
Disability-related resources; and
Other financial, medical, or community assistance programs for which the individual may qualify.

Help clients complete applications, renewals, recertifications, and other required benefit documentation.
Assist clients in gathering necessary supporting documents and understanding deadlines and program requirements.
Help clients respond to requests for additional information from benefit agencies.
Assist clients with understanding correspondence, eligibility notices, renewal notices, and other benefit-related communications.
Provide education regarding the importance of maintaining benefits and completing required renewals or reporting changes when applicable.
Refer clients to appropriate legal, advocacy, governmental, or community resources when an issue exceeds the scope of the Benefits Specialist position.

2. CCBHC Care Coordination and Client Support

Support Kanza’s CCBHC care coordination responsibilities by helping individuals navigate behavioral health care, physical health care, social services, public assistance programs, and other systems affecting their health and recovery.
Work collaboratively with members of the client’s treatment team to identify financial, insurance, housing, food, transportation, or other social needs that may create barriers to treatment.
Assist in connecting individuals to resources that support recovery, independence, stability, and successful participation in treatment.
Participate in person-centered and family-centered care coordination activities when appropriate and authorized by the client.
Coordinate with internal Kanza programs and external community partners to reduce duplication of services and improve continuity of care.
Promote timely access to resources and benefits that may assist individuals in obtaining behavioral health services, physical health services, medications, housing, food, transportation, and other necessary supports.
Advocate for clients within the scope of the position while promoting client choice, dignity, self-determination, and independence.
Maintain awareness of community needs and identify gaps or recurring barriers affecting individuals served by Kanza.
Support Kanza’s commitment to providing services regardless of an individual’s ability to pay, place of residence, or other barriers to care.

3. Community Resource Coordination

Develop and maintain working relationships with local, state, and federal benefit agencies and community organizations.
Maintain current knowledge of available resources throughout Kanza’s service area and surrounding communities.
Coordinate, as appropriate, with entities such as:

Kansas Department for Children and Families (DCF);
KanCare managed care organizations;
Social Security Administration;
Medicare and Medicaid resources;
Housing authorities;
Food assistance organizations;
Local health departments;
Hospitals and primary care providers;
Aging and disability resource organizations;
Transportation providers;
Utility assistance programs; and
Other social and human service agencies.

Provide clients and Kanza staff with accurate and current information regarding community programs and eligibility resources.
Participate in community meetings, outreach activities, or resource events as requested.
Assist with developing and maintaining an organized resource directory for staff and clients.

4. Client Advocacy and Education

Explain benefit programs and processes in clear, understandable language.
Help clients develop the skills necessary to independently manage their benefits whenever possible.
Provide assistance in a manner that is respectful of each individual’s preferences, culture, abilities, circumstances, and recovery goals.
Identify barriers to obtaining benefits and work collaboratively with the client and treatment team to identify reasonable solutions.
Support clients in communicating with benefit agencies and other organizations.
Provide information regarding appeal or reconsideration processes when benefits are denied and assist clients in locating appropriate advocacy or legal resources when needed.
Maintain professional boundaries and avoid making legal, financial, or eligibility determinations outside the scope of the position.

5. Documentation and Follow-Up

Complete timely, accurate, and professional documentation of client contacts, referrals, applications, assistance provided, and follow-up activities in accordance with Kanza policy and program requirements.
Track benefit applications, renewal deadlines, pending documentation, approvals, denials, and follow-up needs.
Follow up with clients and outside agencies as appropriate to assist with continuity of benefits.
Maintain accurate records necessary for program reporting, quality improvement, CCBHC requirements, and organizational performance measures.
Communicate relevant information to authorized members of the treatment team while maintaining appropriate confidentiality.
Assist with tracking trends related to benefits access and barriers affecting Kanza clients.

6. Confidentiality and Compliance

Maintain strict confidentiality of client information in accordance with HIPAA, applicable federal and state confidentiality laws, Kanza policies, and professional standards.
Obtain appropriate releases of information before communicating with outside agencies or individuals when required.
Protect personally identifiable information, financial information, medical information, and other confidential client information.
Follow all Kanza policies, procedures, compliance requirements, and ethical standards.
Complete required organizational, CCBHC, compliance, privacy, safety, and job-specific training.
Maintain documentation and records in accordance with organizational and regulatory requirements.

7. Team Collaboration

Work collaboratively with Kanza clinicians, case managers, care coordinators, peer support specialists, nursing staff, medical providers, crisis staff, front office staff, and other members of the interdisciplinary treatment team.
Participate in team meetings, care coordination meetings, case consultations, and other meetings as assigned.