Client Benefits Coordinator - Medical (38230)

Job Summary

The Client Benefits Coordinator is responsible for managing and coordinating benefits related to Medicaid, Medicare, and other insurance programs. The coordinator will serve as a liaison between clients, Client Services, Health Services, medical providers, and other funding sources. This role ensures accurate processing of medical claims and payments, pharmacy benefits, specialized medical equipment (SME), and medical supply purchasing. All employees are expected to advocate for the best interest of Emmaus clients and demonstrate Emmaus Core Values in all aspects of their job.

Emmaus Core Values

Core Values: Customer Centered, Integrity, Initiative, and Collaboration.

All employees are expected to advocate for the best interest of Emmaus clients and demonstrate Emmaus' Core Values in all aspects of their job.

Key Responsibilities

• Coordinate Medicaid and Medicare benefits for eligible clients.
• Supply necessary medical information to insurance companies, the Department of Social Services, the Social Security Administration, and the Department of Mental Health.
• Monitor insurance claims related to pharmacy, medical services, and equipment.
• Verify medical claims, including physician and pharmacy bills, to confirm services received.
• Resolve discrepancies in billing, coverage, or claims with providers.
• Process medical payments through bill pay system.
• Process monthly Medicaid Spenddown payments.
• Oversee client pharmacy benefit plans, supporting clients with selecting affordable plans that ensure they receive the necessary medications.
• Collaborate with Health Services and Client Services to facilitate the coordination of insurance claims, advocate for cost-effective solutions, and ensure comprehensive coverage.
• Assist Client Services in helping obtain client medical equipment and supplies through insurance (hospital beds, wheel chairs, other assistive devices).
• Support audits and surveys by preparing required documentation and reports.
• Other client accounting duties as assigned.

Standard - Demands of the Job

• Able to perform functions described in the key responsibilities.
• Able to assist with lifting, transferring or moving up to 25 pounds.
• Hybrid position, requiring flexibility based on need.
• Proficient writing, speaking and communications in English.
• Able to effectively present information and respond to questions from groups of coworkers, clients, and family/guardians.
• Establish and uphold an organizational system that promotes efficiency and effectiveness.
• Able to interpret a variety of instructions in written, oral, diagram or schedule form.
• Able to perform basic accounting functions.

Job Requirements/Desired Education and/or Experience

• High School Diploma or equivalent required.
• 2 plus years of administrative experience required.
• Intermediate knowledge of MS365 required (i.e. Word, Excel, Outlook).
• Strong communication, organizational, and interpersonal skills required.
• Strong math and analytical skills required.
• Preferred experience interacting with agencies such as the Department of Social Services, Medicaid, Medicare, or the Social Security Administration.
• Preferred experience in reviewing and analyzing medical claim data and related documentation.