Patient Benefit Coordinator - Fort Worth, United States - MHMR Tarrant

Description

For over 50 years, MHMR has provided community-based services for youth and adults with intellectual and developmental disabilities (IDD), mental health conditions, and substance use disorders, as well as babies and young children with developmental delays.

MHMR employees use a person-centered approach to fulfill the mission: We Change Lives Using innovative approaches, MHMR partners with community organizations to provide services and a hopeful future.

Category:
Direct Care - Clinical Therapist/Social Work/Case Worker
Pay is determined by relevant experience, work history, education and internal equities.

As part of our Diversity, Equity, and Inclusion practices, MHMR offers the maximum compensation for candidates based on their experience, education and internal equities of the agency.

This practice removes biases in compensation and assist hires and/or promotions on pay equity in their appropriate position(s) at MHMR.

The average rate for this position is
I) Job Purpose
A) Under the direction of the Benefit Connection Program Manager, this position performs a variety of functions based on the agencies' changing needs. The Benefit Caseworker (BCW) team's primary duty is to establish and maintain an individual's access to relevant benefits.

These duties include assisting MHMR Tarrant County individuals in obtaining SSI/SSDI benefits along with Medicaid/ Medicare and supporting through the application process.

The BCW will assist with the completion of forms and preparations of medical records, as required by SSA. BCW will provide consultation and direct assistance for individuals throughout the entire SSI/SSDI application process. The position also requires basic knowledge of software and data system programs.
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II) Essential Functions
A. Contact all claimant referrals and screen for SSI/SSDI disability benefit eligibility qualifications.
B. Schedule with claimant according to and determined by screening status.
C. Assist with SSI/SSDI application – Medicaid/Medicare– using SSA SSDI/online and SSI/8001 processes.
D. Assist with the required documentation, medical release, and medical appointments related to the disability determination process.
E. Follow claim and establish relationship between claimant and Medical Examiner (DDS) through the day review process.
F. Schedule and assist with PERKS (favorable claims); complete and return requested documentation and the complete transitional process.
G. If payee is required, educate and direct claimant to responsible choices.
H. If an Initial Denial is received, complete Reconsideration/Appeal online. Repeat steps 4-7.
I. If a Secondary Denial is received, assist with online filing for ALJ Hearing Appeal. Direct claimant to BCT Representation or an approved attorney list.
J. Return all claimant calls and follow up with claim assistant, including assistant with ADL completion.
K. Open and review SSA/DDS mail when required, with attention to time sensitive material.
L. Follow up with DDS medical record requests.
M. Assist with transitions into "IN PAY" status, especially for those in suspense status.
N. Provide assistance with all reduced payment situations.
O. Provide assistance for all payee changes and SSA 'in office' changes.
P. Assist, complete and file all Disability Recertifications.
Q. Return interagency calls, and emails.
R. Screen and Complete 95% of Consumer Benefits Referrals and process eligible SSI/SSDI claims on a weekly basis.
S. Complete 95% of BCT Spreadsheets on a weekly basis.
T. Complete SAL's in a timely manner according to MHMRTC policy.
U.

Follow claims (when possible) throughout the entire process, despite clinic transfers, home plan changes and out of County and State changes.

V. Complete and update BCT Spreadsheets on a weekly basis
W. Provides clinical consultation and training to QMHPs as necessary to ensure clinical and professional accountability.
X. Participate and contribute to Program Planning, Policy Development, and Inter-Agency Coordination of Medicaid Service Program.
Y. Attends program development meetings, and performs inter-agency research projects to contribute to program planning activities.
Z. Completes development projects as assigned by the supervisor, and submits results as scheduled.
AA.

In accordance with the Random Moment in Time Study (RMTS), this staff person is officially involved in program, policy development, and inter-agency coordination of Medicaid service programs.

This includes participation in regular scheduled meetings to develop strategies to increase Medicaid system capacity, focus Medicaid services on specific populations, etc.

A. Complete additional duties as assigned.
B. Performance standards are performed as applicable with MHMR's We CARE values "We Connect People in Our Community. We Provide Access to Services. We Link People to Resources. We Empower People."
C. Perform other job duties or responsibilities as requested or assigned.
III) Knowledge of Laws, Regulations, Policies/Procedures, Skills, and Abilities

A) MHMRTC Policies and Procedures, SSI/SSDI applications, representation and appeal procedures, Department of Assistive and Rehabilitative Services (DARS) documentation procedures, work incentive programs and procedures related to other benefits programs as provided by the supervisor.

Advanced language skills (both written and verbal)
B) Effective interpersonal skills
C) Working knowledge of MHMRTC services and area resources for individuals with disabilities.
D)

Required computer skills include:
data entry in approved agency computer systems, documents in Microsoft Word, and the use of e-mail.
E) Ability to learn new information easily and in an efficient manner.
F) Ability to comply with agency dress code standards.
IV) Internal & External Customer Service
A) Senior Director ABH
C) Program Directors
D) Program Managers
G) Recovery Resource Center
H) Department State Health Services (HHSC)
I) Other MHMR programs
J) Family Members
K) Administrative judges
V) Travel
A) Requires occasional overnight state-wide travel and may require ride sharing using personal and/or available company vehicle (with completed Defensive Driving course)
B) Requires local travel in personal vehicle between MHMR Tarrant clinics, community and social security offices as needed.
C) May require temporary or permanent re-assignment to any of the clinics as determined by program needs.
VI) Equipment Used
A) Car (personal and/or agency)
B) Telephone/Mobile Phone
C) Alarm system
D) Copy machine
F) Computer
G) WiFi Hotspot
H) Household appliances
I) Other general office equipment
J) Other equipment related to client training needs
i) Staff member is responsible to report lost, stolen, or broken equipment to his or her supervisor immediately
B)

Defined Education:
Social, behavioral health, and human service Business,

C) Preferences:

D) Substitutions:
F)

Defined Experience:
None


G) License/Certifications:
i) Valid Texas Driver's License
ii) Proof of Liability Insurance Coverage
iii) Successful completion of required organizational training

H)

Special Courses:
None

I)

Supervisory Experience:
None

VIII) Agency Requirements
A) All staff are required to participate in agency Emergency Preparedness and Environmental Safety programs and may be assigned by their department as a key/essential staff level function during critical events or for the purpose of sustaining business continuity.
B) This position may require temporary or permanent re-assignment to any MHMR Tarrant facility as determined by program needs and/or the Division/Director.
C) Assigned work hours may change as the needs of the agency change.
D) The Functional Title of this position may change as the needs of the agency change.
E) All work will be completed within the scheduled work hours.

All non-exempt (hourly) employees are expected to clock in and clock out for each work shift, no work should be done off the clock.

F) Prior approval from supervisor is required for all Paid Time Off (PTO) and Overtime.
G) MHMR reserves the right to change, add to or eliminate positions as it deems appropriate.
H) Employment is at will, as well as agency needs may change.
I) Agency dress code is to be followed at all times.
J) Physical on-site presence, including regular attendance and punctuality, is an essential function of this position.

Any changes or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.

This position requires extensive contact and effective communication with applicants, family members, and representatives of other agencies, Administrative Law Judges, and health professionals.

This is accomplished with advanced written and verbal skills utilized in private and public exchange of information.

As a representative of MHMR Tarrant and the individuals we serve, this position requires the ability to establish and maintain positive, effective, respectful, and ethical working relationships with others at all times.

Physical/Mental Characteristics

Note:
Check the physical, mental, and environmental conditions of the essential functions of the job.
Our total rewards program offers benefits* to full time employees beginning 1st of the month following hire date including but not limited to:

• Comprehensive healthcare options (Medical, Dental, and Vision)
• Life insurance and additional supplemental accident and hospitalization plans
• 401a match and 457 deferred compensation plans
• Paid vacation and holidays; varied flexible work environment locations
• Student Loan Forgiveness
• Professional development programs and training

Insurance eligibility:

• Full time employees begin 1st of the month following hire date
• Market driven positions (full time or part time) begin immediately after hire date
• Select part time market driven positions are eligible for most insurance plans
• Substitute status jobs are not eligible for benefits

Additional Information
*MHMR of Tarrant County ("MHMR") and its affiliates and subsidiaries have an internal recruiting department. MHMR may supplement that internal capability from time to time with assistance from temporary staffing agencies, placement services, and professional recruiters herein after referred to collectively as "Recruiters"). Recruiters are hereby specifically directed NOT to contact MHMR employees directly in an attempt to present candidates – MHMR recruiting team or other authorized MHMR personnel must present ALL candidates to hiring managers. For more information please visit our website

MHMR is an equal opportunity employer.

MHMR prohibits employment discrimination based on race, color, religion, sex, national origin, age, covered veteran status, disability, sexual orientation, trans-gender, gender expression, gender identity or any legally protected characteristic.

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7,472,097; 7,606,778; 8,086,558 and 8,046,251.

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