The Financial Benefits Assistant is a key associate at Hope Network whose primary responsibilities include: Assist the Financial Benefits Specialist with benefits enrollment, benefits tracking, and the maintaining of benefits for all consumers with Behavioral Health case management services. Adhere to all guidelines set forth by the Social Security, Licensing, CMH’s, DHHS, and CARF requirements. Provide clerical and administrative support within the Business Services team.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
This is not intended to be an exhaustive listing of job functions. This job description in no way states or implies that these are the only duties to be performed by this employee. The employee is required to follow any other instructions and to perform any other duties as assigned.
Regular and predictable attendance is an essential requirement of this position.
1. Assist in gathering key supporting documentation when consumer moves between program or first arrives.
2. Assist in managing reporting of consumer Medicaid spend downs.
3. Support the overall process of ensuring consumer eligibility for benefits.
4. Complete benefits applications (e.g. Medicare/Medicaid/SSI-SSDI/Bridge Card) applications for consumers, as needed. Assist in the completion of reapplication of benefits if denied.
5. Assist in communicating or distributing Benefit information as needed to facilitate services to the consumer.
6. Complete the DHS “level of care” form when consumer moves between program or first arrives.
7. Attend Network 180 general fund meetings as requested.
8. Assure that Medicaid spend down requirements are met to maximize coverage and eligibility for benefits.
9. Establish, restore, verify, and increase eligibility for benefits whenever possible.
10. Function as the Hope Network Representative Payee for all consumers whom Hope Network is serving as Social Security Representative Payee
11. Monitor the Consumer’s finances and the Consumer Fund account for financial transactions and payments. Prepare payments and personal spending reports weekly, monthly and yearly.
1. Collect necessary data from programs and process monthly food stamp benefits collection through POS system and provides appropriate documentation to the accounting department for the distribution of revenue by program. Provide feedback to Program Managers for necessary corrections and follow up.
2. Assist with preparation and distribution of monthly reports to program directors, case managers, Director of Operations and Manager of Facilities and Operations. Reports will include status of benefits (Medicaid/Medicare/SSI-SSDI-RSDI/Bridge cards).
3. Preparation of annual and periodic reports as required by Social Security (e.g. representative payee report), Department of Human Services (DHS) and the CMH organizations.
4. Collect financial data (e.g. Financial Determination Worksheet) to assist in completing the CMH agencies “Ability to Pay” fee determinations.
5. Review medical and pharmacy invoices for accuracy and cost savings opportunities.
Assist in resolving disputed invoices.
6. Review and audit the Residential Funds at each individual program for accuracy and compliance with CMH guidelines relating to Residential Funds Part I and Part II documentation.
7. Report to the Benefits specialist and his supervisors any errors or discrepancies that need to be addressed. This function to be performed at least twice a year.
8. The Financial benefits assistant will help with the preparation of consumer’s personal fund checks, cost of care payments and other financial transaction for the Individual consumers that HNBHS is the Social Security Representative payee for.
9. The Financial benefits assistant will help maintain and balance the consumer fund account as transactions occur throughout the month.
1. Maintain proficiency in regulations of FIA, Social Security, and governing legislation (including HIPAA) to assure compliance.
2. Work effectively with the directors, managers, coordinators of the admissions, quality, rights, compliance and safety departments to ensure appropriate services are provided.
3. Work with BHS consumer information coordinator and accounting department to make sure benefits information is correct in the ECR.
4. Maintain proficiency in regulations of FIA, Social Security, and governing legislation (including HIPAA) to assure compliance.
5. Assists in training fellow employees in the use of e-Care and the proper disposition of electronic, audio, and paper documents.
6. Other duties as assigned.
Educational / Talent Requirements:
1. Minimum Education required: High School Diploma or GED
2. Demonstrated ability to communicate in written and verbal formats in order to meet position requirements.
3. Ability to work autonomously and with a team
4. A current Michigan driver’s license with a driving record acceptable to Hope Network insurance carrier’s definitions.
Work Experience Requirements:
1. One (1) to two (2) years’ experience in an administrative / clerical role.
2. Basic knowledge of windows based software including detailed spreadsheet experience