Resident Benefits Manager

IRENE WORTHAM CENTER - POSITION DESCRIPTION

Position Summary

Resident Benefits Specialist is responsible for managing Social Security Administration communications, coordinating resident benefits, completing required Social Services documentation and reporting, and serving as a liaison with guardians, family members, healthcare providers, and government agencies. This role ensures timely resolution of billing issues, maintains accurate records, and supports residents in obtaining and maintaining eligible benefits and services.

Essential Duties & Responsibilities

1. Serve as the primary contact for Social Security Administration (SSA) inquiries, applications, benefit verification, changes, appeals, and resident eligibility matters.
2. Communicate regularly with residents, guardians, family members, and representatives regarding benefits, financial obligations, and required documentation.
3. Complete, process, and maintain paperwork for various Social Services programs, including Medicaid, Medicare, disability benefits, and other public assistance programs.
4. Prepare and submit required reports to government agencies, regulatory entities, and internal management.
5. Monitor benefit renewals, recertifications, and deadlines to ensure continued eligibility and compliance.
6. Investigate and resolve physician, hospital, pharmacy, and other healthcare provider billing discrepancies.
7. Coordinate with medical providers, insurance carriers, Medicare, Medicaid, and third-party payers to resolve outstanding claims and unpaid balances.
8. Maintain accurate resident financial and benefits records in accordance with organizational policies and regulatory requirements.
9. Assist with admission, discharge, and resident status changes that impact benefits and financial accounts.
10. Track resident accounts and follow up on outstanding documentation needed for benefit approvals or reimbursement.
11. Collaborate with Social Services, Business Office, Nursing, and Administration departments to address resident concerns and ensure continuity of services.
12. Ensure compliance with federal, state, and local regulations related to resident benefits and financial reporting.
13. Provide administrative support related to resident funding sources, guardianship documentation, and benefit management.

Non-Essential Duties & Responsibilities:

Maintain valid North Carolina’s Driver’s License and good driving record.

Education/Training

Associate’s degree in social work human services, Business Administration, Healthcare Administration, or related field preferred.

Special Skills/Abilities

Experience working with Social Security, Medicaid, Medicare, long-term care, skilled nursing, assisted living, or social service programs preferred.

Knowledge of government benefit programs, insurance billing, and healthcare reimbursement processes.

Strong organizational, communication, and problem-solving skills.

Ability to manage multiple deadlines and maintain confidential information.

Proficiency in Microsoft Office and electronic recordkeeping systems.

Contacts Inside/Outside Organization

IWC/IWRC staff, Stakeholders, Board Members, parents/guardians, client families, Foster Grandparents, and Volunteers.

Other Qualifications or Requirements

Mental Effort:                            Ability to understand and follow complex verbal and written instructions. Ability to function independently.

Visual Effort:                             Well-lighted office environment requiring average amount of visual effort.

Physical Requirements:              Office environment not usually requiring ongoing strenuous physical qualifications.  May require occasional lifting of 25 pounds.

Safety:                                      Typically, a low risk of injury due to typical office environment.  IWC’s philosophy is to provide the safest work environment possible while meeting requirements from OSHA and other regulatory agencies.

Working Conditions:                   Well lighted and ventilated, even temperature, accessible parking. Work will be primarily indoors.

Scope of Position:                     Number of employees supervised:   0