Network Benefits Specialist

**ABOUT THE ORGANIZATION** - Monroe Community Mental Health Authority is a community based mental health service organization dedicated to consumers living in Monroe County. We provide individual health services for people with any type of behavioral health concerns such as substance abuse, emotional issues, and intellectual and developmental disabilities. - Our mission is to enrich lives and promote wellness. We live out that mission by being an inviting resource that offers in-house, referral, and emergency services, as well as support within the community for those in need. **BENEFITS** - Bi-weekly pay - Vacation, sick, and personal time - Four medical plans to choose from, eligible first day of hire - Dental - Vision - Aflac - Disability and life insurance provided by the Agency, optional buy-ups - 401a Money Purchase Pension Plan, 401a Defined Contribution, and 457 Deferred Compensation retirement plans - YMCA corporate discount **DESCRIPTION** **Summary:** The Network Benefits Specialist position is responsible for completing the initial consumer registration process, determining on an annual and on an as-needed basis the method of consumer reimbursement to the Agency for services provided, ensures consumer insurance information is accurate and up to date in the electronic health record (EHR), and assists with determining whether or not applicants for various programs meet the necessary qualifications. The Network Benefit Specialist provides direct support, if necessary, for the application process as well as follow-up of submission and review of process. This position also ensures consumers maintain their benefits by tracking all Medicaid programs. **Duties and Competencies** 1. Interviews new consumers soliciting information from such to complete admission forms and consumer registration process. 1. Collects information regarding income, assets, liabilities, level of benefits, insurance coverage, etc. to assess in accordance with standards established by the Board and MDHHS the individual’s ability to pay for services provided by the Board. Processes fee agreement forms, assignment of benefits forms and other forms and information necessary to open consumer accounts consistent with standards established by the Board, MDHHS, state and federal agencies, and private third-party payors. 1. Schedules appointments and assesses financial information provided by open consumers to determine their ability to pay for services on an annual basis or as required because of changes in income, insurance, current status, etc., consistent with standards established by the Board, MDHHS, state and federal funding agencies, and private third-party payors. 1. Completes computer entry of information related to abilities to pay, financial resources, etc. implementing control functions and reconciling consumer accounts according to Board established policies. 1. Processes payments received from individuals and third party payors. 1. Conducts annual reviews to ensure insurance information is current and accurate. 1. Completes Medicaid applications upon intake for all MCMHA consumers, as necessary. 1. Completes assigned shared job functions (Medicaid Deductible/Family Support Subsidy) timely, and submits to Michigan Department of Health and Human Services (MDHHS) as required 1. Reviews applications for various aid programs (i.e., Medicaid application, Food Assistance, any MDHHS program) to ensure that applicants are eligible. This entails assisting with the completion of the application process and/or verifying that any application forms have been filled out correctly and checking the information on the forms for accuracy. This may require specialist to follow up with applicants multiple times. 1. Verifies insurance information in the MCMHA Electronic Health Record (EHR), adding and updating insurance layers. 1. Ensures appointment are scheduled correctly based on physician credentialing. 1. Analyzes data to identify trends and areas for improv…