Job Summary: The Wellness Services Benefits Counselor has the primary responsibility of assessing patients' eligibility for insurance and other health care access supports such as patient assistance programs, social services, and Project HOME's sliding fee schedule. This role is essential for patient access to specialty care and medications as well as for the Wellness Center's fiscal sustainability.

Essential Duties and Responsibilities

• Ensure that sliding fee applications are completed and entered in Nextgen on an annual and as-needed basis. Communicate sliding fee structure for patients who qualify for the sliding fee schedule.
• Screen each uninsured patient for eligibility for Medicaid and/or Affordable Care Act Health plans. Based on screening, complete and submit applications for applicable insurance.
• Act as Front Desk Receptionist when coverage is needed
• Support referral coordinator with referral submission and management as needed.

Other Functions:

• Review electronic eligibility reports on a daily basis and verify eligibility for those that did not process, and patients added same day.
• Assist patients with applying for and maintaining Medicaid/Marketplace/ Medicare and supplemental insurance programs
• Provide coverage and support for Medical/Dental Receptionists during vacations, sick time, and lunch breaks
• Scheduling and recruiting new patients for the Wellness Center
• Support the referral coordinator in processing medical referrals and prior authorizations for all medical patients
• Support the dental receptionist and dental assistants in processing prior authorizations and Benefit Limit Exceptions.
• Develop and update Resource Guide for the Wellness Center on a quarterly basis.
• Network with Community Umbrella Agencies and other external organizations to bring in new patients.
• Support the referral coordinator in scheduling patients for specialist appointments and procedures.
• Maintain record of Medicaid applications submitted for our patients.
• Monitor and ensure accurate information is entered in the practice management system for all patients.

The information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job. Management may, at its sole discretion, assign or reassign duties and responsibilities to this job at any time.

Minimum Qualifications

• Bachelor's degree or more than 2 years' experience in an FQHC or similar health center setting required
• Strong computer and organizational skills. Ability to build a spreadsheet using Excel is preferable.
• Ability to manage multiple tasks simultaneously.
• Ability to work independently and to collaborate as a member of a team.
• Prior experience delivering services to persons with histories of homelessness, mental illness, substance dependence, and trauma would be helpful.

Preferred Qualifications

• Bachelor's degree or more than 2 years' experience in an FQHC or similar health center setting required.
• Ability to speak a second language other than English preferred.
• Excellent communication skills both oral and written
• Excellent interpersonal skills
• Ability to work accurately and pay close attention to details
• Ability to apply critical thinking skills
• Knowledge and experience in apply for Medicaid insure through Pennsylvania Compass system
• Ability to analyze data, forecast and plan, work under pressure, solve problems, accept and implement change.

Physical requirements

Light lifting

Project HOME provides equal employment opportunities to all employees and applicants for employment, without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws. Project HOME prohibits discrimination and harassment of any type.