Benefits Specialist

POSITION TITLE: Benefits Specialist 

REPORTS TO: Manager of Health Information and Revenue Cycle, Director of Finance and Operations 

DIRECT REPORTS: None 

FLSA STATUS: Non-Exempt; Regular Full-Time; Employment-at-Will Position 

SCHEDULE: Full-time, 40 hours per week, generally Monday through Friday during Kanza Mental Health & Guidance Center’s normal hours of operation. Schedule may vary based on client, program, and organizational needs. 

WORK LOCATION: 

This position is employed by Kanza Mental Health & Guidance Center and will work across Kanza and Northeast Kansas Multi-County Health Department settings as necessary to support the collaborative service arrangement. The position may be based primarily at Kanza’s Hiawatha, Kansas office but will be required to travel to Kanza’s Holton, Kansas office, Northeast Kansas Multi-County Health Department locations, and other community locations as necessary to meet client, program, and organizational needs. 

The Benefits Specialist is an employee of Kanza Mental Health & Guidance Center and will work collaboratively with Northeast Kansas Multi-County Health Department and Kanza Mental Health & Guidance Center staff. The Benefits Specialist may receive operational or work-related task assignments from authorized Kanza leadership and, when working within Health Department settings or supporting Health Department programs, will coordinate with designated Health Department personnel consistent with the collaborative service arrangement. 

Such coordination does not alter the Benefits Specialist’s employment relationship with Kanza Mental Health & Guidance Center. Kanza retains responsibility and authority for the employee’s supervision, employment decisions, performance management, compensation, benefits, training requirements, disciplinary action, and compliance with Kanza policies and procedures. Coordination with Health Department personnel is intended to support effective service delivery, communication, and collaboration between the organizations and does not create a separate or joint employment relationship. 

PURPOSE: 

The Benefits Specialist assists individuals served by Kanza Mental Health & Guidance Center and/or Northeast Kansas Multi-County Health Department in obtaining and maintaining health coverage, public benefits, and financial assistance necessary to access behavioral health, physical health, medication, and other essential services. The position also supports both organizations' revenue cycle by assisting with insurance eligibility and coverage issues and serves as a key administrative resource for organizational payer enrollment and related enrollment maintenance. 

ESSENTIAL JOB FUNCTIONS: 

1. Benefits Screening and Assistance 

• Meet directly with clients to identify potential eligibility for federal, state, and local benefit programs and community resources. 

• Assist clients with understanding and navigating programs that may include: 

• Medicaid/KanCare; 

• Medicare; 

• Social Security Disability Insurance (SSDI); 

• Supplemental Security Income (SSI); 

• Supplemental Nutrition Assistance Program (SNAP); 

• Temporary Assistance for Needy Families (TANF); 

• Health insurance and health coverage programs; 

• Prescription medication assistance programs; 

• Disability-related resources; and 

• Other financial, medical, programs for which the individual may qualify. 

• Help clients complete applications, renewals, recertifications, and other required benefit documentation. 

• Assist clients in gathering necessary supporting documents and understanding deadlines and program requirements. 

• Help clients respond to requests for additional information from benefit agencies. 

• Assist clients with understanding correspondence, eligibility notices, renewal notices, and other benefit-related communications. 

• Provide education regarding the importance of maintaining benefits and completing required renewals or reporting changes when applicable. 

• Refer clients to appropriate legal, advocacy, governmental, or community resources when an issue exceeds the scope of the Benefits Specialist position. 

2. Benefits Access and Continuity of Care 
Assist clients in obtaining and maintaining health coverage and other benefits necessary to access behavioral health, physical health, medication, and other essential services. Work collaboratively with treatment teams when benefit eligibility, coverage, or financial barriers may interfere with access to care. Provide benefits-related information and assistance within the scope of the position and refer broader clinical, social, or care-coordination needs to the appropriate Kanza team member. 

3. Benefits and Payer Resources 

• Develop and maintain working relationships with local, state, and federal benefit agencies and community organizations. 

• Coordinate, as appropriate, with entities such as: 

• Kansas Department for Children and Families (DCF); 

• KanCare managed care organizations; 

• Social Security Administration; 

• Medicare and Medicaid resources; 

• Housing/food programs when the role is specifically assisting with eligibility/application for benefits 

• Aging and disability resource organizations; 

• Other social and human service agencies. 

• Provide clients and Kanza staff with accurate and current information regarding  eligibility resources. 

• Participate in community meetings, outreach activities, or resource events as requested. 

4. Client Advocacy and Education 

• Explain benefit programs and processes in clear, understandable language. 

• Provide assistance in a manner that is respectful of each individual’s preferences, culture, abilities, circumstances, and recovery goals. 

• Identify barriers to obtaining benefits and work collaboratively with the client and treatment team to identify reasonable solutions. 

• Support clients in communicating with benefit agencies and other organizations. 

• Provide information regarding appeal or reconsideration processes when benefits are denied and assist clients in locating appropriate advocacy or legal resources when needed. 

• Maintain professional boundaries and avoid making legal, financial, or eligibility determinations outside the scope of the position. 

5. Documentation and Follow-Up 

• Complete timely, accurate, and professional documentation of client contacts, referrals, applications, assistance provided, and follow-up activities in accordance with Kanza policy and program requirements. 

• Track benefit applications, renewal deadlines, pending documentation, approvals, denials, and follow-up needs. 

• Follow up with clients and outside agencies as appropriate to assist with continuity of benefits. 

• Maintain accurate records necessary for program reporting, quality improvement, CCBHC requirements, and organizational performance measures. 

• Communicate relevant information to authorized members of the treatment team while maintaining appropriate confidentiality. 

• Assist with tracking trends related to benefits access and barriers affecting Kanza clients. 

6. Confidentiality and Compliance 

• Maintain strict confidentiality of client information in accordance with HIPAA, applicable federal and state confidentiality laws, Kanza policies, and professional standards. 

• Obtain appropriate releases of information before communicating with outside agencies or individuals when required. 

• Protect personally identifiable information, financial information, medical information, and other confidential client information. 

• Follow all Kanza policies, procedures, compliance requirements, and ethical standards. 

• Complete required organizational, CCBHC, compliance, privacy, safety, and job-specific training. 

• Maintain documentation and records in accordance with organizational and regulatory requirements. 

7. Team Collaboration 

• Serve as an internal resource to Kanza and health department staff regarding Medicaid/KanCare, Medicare, commercial insurance, public benefits, eligibility requirements, renewals, coverage barriers, and available financial assistance programs. 

8. Benefits/Eligibility and Revenue Cycle. 

• Verifying Medicaid/KanCare, Medicare, and commercial insurance eligibility 

• Identifying coverage changes that could affect claims 

• Assisting with payer-related client information 

• Resolving eligibility-related claim denials 

• Assisting with Medicaid/Medicare enrollment or coverage issues 

• Identifying clients who are uninsured or underinsured 

• Helping clients obtain coverage that will pay for necessary services 

• Assisting with financial assistance/coverage applications 

• Communicating with payers regarding eligibility or coverage issues 

• Identifying recurring payer/eligibility problems and communicating them to Revenue Cycle 

• Supporting accurate payer information in the EHR 

• Assisting with documentation needed to establish coverage 

9. Organizational Payer Enrollment and Provider Enrollment Support 

• Manage and maintain Kanza’s and the health departments enrollment with Medicaid/KanCare, Medicare, commercial insurers, and other applicable payers. 

• Complete and submit organizational payer enrollment, revalidation, recredentialing, and change-of-information applications. 

• Maintain accurate organizational information with payers, including addresses, tax identification information, NPI information, service locations, ownership information, and other required documentation. 

• Track payer enrollment status, effective dates, revalidation deadlines, and required documentation to prevent gaps in enrollment. 

• Coordinate with Revenue Cycle, Finance, Operations, and clinical leadership to ensure payer enrollment information remains accurate and aligned with organizational operations. 

• Communicate with payers regarding enrollment issues, application status, revalidation, and changes to organizational information. 

• Maintain organized records of payer contracts, enrollment applications, approvals, correspondence, and related documentation. 

• Identify and escalate payer enrollment issues that may affect Kanza’s ability to bill or receive reimbursement for services. 

• Assist with payer enrollment and credentialing activities related to new programs, locations, or changes in organizational services. 

• Support provider enrollment/credentialing processes as assigned, including tracking provider information and ensuring required documentation is submitted and maintained. 

8. Travel and Community-Based Responsibilities 

• Maintain the ability to work primarily from the Hiawatha, Kansas area while routinely traveling to Atchison and Jackson counties as necessary based on client and organizational needs. 

• Travel throughout Kanza’s service area or to community partner locations when necessary to assist clients or participate in outreach and coordination activities. 

• Maintain a valid driver’s license, reliable transportation, and insurability under Kanza’s automobile insurance requirements when driving is an essential function of the position. 

• Follow Kanza policies regarding travel, mileage reimbursement, transportation, safety, and use of personal or agency vehicles. 

This job description is intended to describe the general nature and level of work performed by employees assigned to this position. It is not intended to be an exhaustive or comprehensive list of all duties, responsibilities, tasks, or expectations associated with the position. Employees may be required to perform additional duties or responsibilities as assigned by their supervisor or Kanza Mental Health & Guidance Center based on client, program, operational, regulatory, or organizational needs. 

Qualifications

MINIMUM QUALIFICATIONS: 

• High school diploma or equivalent required. 

• Associate’s or bachelor’s degree in social work, human services, psychology, sociology, business, public administration, or a related field preferred. 

• Previous experience working in behavioral health, social services, health care, public benefits, eligibility determination, case management, insurance, or a related field strongly preferred. 

• Experience assisting individuals with Medicaid/KanCare, Medicare, Social Security, disability benefits, SNAP, housing assistance, or other public benefit programs preferred. 

• Ability to learn and understand complex eligibility requirements, application processes, and government benefit systems. 

• Strong organizational and time-management skills with the ability to manage multiple client applications and deadlines simultaneously. 

• Strong written and verbal communication skills. 

• Ability to explain complicated information in a clear, patient, and understandable manner. 

• Strong computer skills and ability to learn electronic health records, online government benefit systems, Microsoft Office applications, and other required technology. 

• Ability to maintain confidentiality and appropriately handle sensitive medical, financial, and personal information. 

• Ability to work independently while functioning effectively as part of an interdisciplinary team. 

• Ability to work effectively with individuals experiencing mental health conditions, substance use disorders, financial hardship, homelessness, disability, or other significant life challenges. 

• Demonstrated ability to interact respectfully and professionally with individuals from diverse backgrounds and circumstances. 

• Bilingual skills are a plus. 
   

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES: 

The successful candidate must demonstrate: 

• Knowledge of or ability to learn federal, state, and local public benefit programs. 

• Understanding of the relationship between social determinants of health and an individual’s ability to successfully participate in treatment and recovery. 

• Strong client-service and advocacy skills. 

• Ability to establish rapport while maintaining appropriate professional boundaries. 

• Ability to collect, organize, and maintain detailed documentation. 

• Ability to prioritize deadlines and follow applications through completion. 

• Ability to collaborate with multiple internal departments and external agencies. 

• Effective problem-solving and critical-thinking skills. 

• Ability to work with clients who may be frustrated, overwhelmed, experiencing symptoms of mental illness, or facing significant financial or social stressors. 

• Commitment to person-centered, recovery-oriented, trauma-informed, and culturally responsive services. 

• Ability to demonstrate patience, professionalism, empathy, and respect in all interactions. 

• Understanding of confidentiality, privacy, and ethical responsibilities associated with access to protected client information. 

CCBHC RESPONSIBILITIES: 

As an employee of a Certified Community Behavioral Health Clinic, the Benefits Specialist is expected to support Kanza’s commitment to: 

• Providing timely and meaningful access to behavioral health services. 

• Supporting individuals regardless of their ability to pay or other barriers to care. 

• Providing person-centered, family-centered, recovery-oriented, and trauma-informed services. 

• Coordinating behavioral health care with physical health care, social services, and other community systems. 

• Supporting targeted care management and coordinated access to necessary community supports. 

• Identifying and addressing social needs that may interfere with treatment, recovery, health, and community stability. 

• Working collaboratively with community organizations and other health and human service providers. 

• Supporting continuity of care across providers and service settings. 

• Participating in quality improvement efforts and required data collection as applicable to the position. 

• Treating individuals receiving services as active partners in decisions affecting their care and recovery. 

PHYSICAL AND WORK ENVIRONMENT REQUIREMENTS: 

• Ability to perform routine office functions including prolonged periods of sitting, computer use, telephone communication, and documentation. 

• Ability to travel between Kanza locations and community sites as required. 

• Ability to occasionally lift and carry office materials and supplies consistent with normal office duties. 

• Ability to interact with clients in office and community-based settings. 

• Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position. 

OTHER DUTIES: 

This job description is intended to describe the general nature and level of work performed by the Benefits Specialist. It is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Responsibilities may be modified or additional duties assigned based on client, program, regulatory, CCBHC, and organizational needs. 

Employment with Kanza Mental Health & Guidance Center, Inc. is at will. Nothing contained in this job description creates or is intended to create a contract of employment. 

COMPENSATION: This is an hourly, non-exempt position. The starting wage will be determined based on the selected candidate’s education, relevant experience, qualifications, internal equity, and Kanza Mental Health & Guidance Center’s established compensation structure. 

SALARY AND WAGE DISCLAIMER: Any wage, salary, or compensation range provided in a job posting, advertisement, or other recruitment material represents Kanza Mental Health & Guidance Center’s good-faith estimate of the compensation expected for the position at the time of posting. Actual compensation may vary based on factors including, but not limited to, education, licensure or certification, relevant experience, qualifications, internal equity, organizational needs, and applicable compensation guidelines. Nothing contained in a job posting or job description constitutes a guarantee of a specific wage, salary, compensation level, or future wage increase.