GENERAL SUMMARY

The Consumer Benefits Specialist III will provide consumers specialized assistance in determining and securing benefits, to include representing consumers at SSI/DI appeals hearings, and complete associated documentation for the consumer and program.

ESSENTIAL DUTIES & RESPONSIBILITIES

Essential functions are the basic job duties that an employee must be able to perform, with or without reasonable accommodation. The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. The omission of a function does not preclude management from assigning essential duties not listed herein if such duties relate to the position.

· Maintains current knowledge of regulations and reference materials related to benefit claims.

· Monitors eligibility profiles of Mental Health Clients to identify potentially eligible applicants for benefit determination and application or to ensure eligibility for benefits are not lost through oversight.

· Performs SSI/DI, CHIP, Medicaid Only, & Medicare supplements financial and medical screenings, complete benefits forms with potentially eligible clients, summarize medical and interview information, submit complete application to Social Security Administration.

· Provides Mental Health consumers with assistance in determining eligibility for, accessing of, and maintaining benefits; and entitlement while strengthening the individual's financial resource base.

· Represents clients in denied SSI/DI claims acting as lead representative for Administrative Law Judge (ALJ) and The Center for Health Care staff.

· Screens clients denied SSI/DI for eligibility to appeal.

· Performs other related duties as required.

Children’s Behavioral Health

· Performs essential duties & responsibilities of Consumer Benefits Specialist II & III from initial application to representing the consumer at the Administrative Law Judge Hearings with Social Security Administration.

MINIMUM ENTRANCE QUALIFICATIONS

Education and Experience

· High School Diploma or GED and a minimum five (5) years of experience in a health care environment and two (2) years of social security experience including representation of clients at hearing level.

· Experience with benefit enrollment application completion and processing, Medicaid Administrative Claiming (MAC) practices and procedures, Texas Rehabilitation Commission (TRC).

Licenses or Certifications

· None

Other Requirements

· Must maintain a valid driver’s license and automobile insurance coverage, be able to travel as needed, and be able to meet on a consistent basis the driving record requirements of the Company’s auto insurance carrier if you drive your vehicle during company business.

· Must maintain required credentials and mandatory training requirements to ensure compliance with all State regulations and CHCS policies.

· Must be able to meet the physical requirements to complete Nonviolent Crisis Intervention (NCI) and CPR training including lifting up to 12 lbs. and supporting up to 55 lbs.; bending, stooping and getting on and off the floor without assistance.

· Nonviolent Crisis Intervention (NCI) is a proven safe and harm-free method of behavior modification. All consumer-facing employees of CHCS must take NCI courses facilitated by the CHCS Training team within the first 45 days of employment.

· NCI is intended to support human service professionals in giving aggressive, disruptive, or out-of-control people the best care and welfare possible, even in the most violent situation.

· NCI training provides staff with the skills to safely recognize and respond to everyday crisis situations that may involve more challenging behaviors. It focuses on prevention and offers proven strategies for safely defusing anxious, hostile or violent behavior at the earliest possible stage.

· Depending on assigned unit/program, applicants for this position must pass a Criminal Justice Information Systems (CJIS) fingerprint-based background check and maintain CJIS eligibility. Due to CJIS requirements related to system access, the following may result in being disqualified for this position: Felony Convictions, Felony Deferred Adjudication, Class A & B Misdemeanor Deferred Adjudication, Class B Misdemeanor Convictions, an Open Arrest for Any Criminal Offense (Felony or Misdemeanor), and Family Violence Convictions.

PREFERRED QUALIFICATIONS

· Bachelor's degree in Business Administration, Public Health Administration, or a Behavioral Science.

SUPERVISION

· Job has no responsibility for the direction or supervision of others.

COMPETENCIES FOR SUCCESSFUL PERFORMANCE OF JOB DUTIES

Knowledge of:

· Applicable software applications

· Benefits eligibility requirements

· Modern office procedures, methods and computer equipment

· Proficiency with spread sheets using Microsoft Excel

· Regulations and reference materials related to benefit claims

· Revenue recognition experience

· Screening clients denied SSI/DI for eligibility to appeal

Skilled in:

· Conducting interviews

· Organization and time management

· Performing a variety of duties, often changing from one task to another of a different nature

· Performing basic mathematical functions such as addition, subtraction, multiplication, division, percentages, and ratios

Ability to:

· Accurately organize and maintain paper documents and electronic files

· Effectively communicate, both verbally and in writing

· Establish and maintain effective working relationships

· Maintain accurate and complete records

· Maintain the confidentiality of information and professional boundaries

· Meet schedules and deadlines of the work

· Represent clients in denied SSI/DI claims acting as lead representative for Administrative Law Judge (ALJ) and Center staff

· Screen clients for eligibility

· Understand and carry out oral and written directions

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· Must be able to meet the physical requirements to complete Nonviolent Crisis Intervention (NCI) and CPR training including lifting up to 12 lbs. and supporting up to 55 lbs.; bending, stooping and getting on and off the floor without assistance.

· Must have adequate mobility that requires frequent walking, standing, bending, stooping, kneeling, reaching (vertical and horizontal), and using fingers, hands, feet, legs and torso in various care.

Job Type: Full-time

Pay: $17.08 - $21.35 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• in a health care environment: 5 years (Required)

Ability to Relocate:

• San Antonio, TX 78238: Relocate before starting work (Required)

Work Location: In person