The Parkland Community Health Plan (PCHP) SSI Specialty Coordinator is responsible for screening and processing potential health plan members and working with the Social Security Administration to enroll eligible members who meet criteria for enrollment in the Supplemental Security Income (SSI) program.
Education - Associate degree is required.
- Five years of experience in a Health Services or Healthcare environment working with Social Security, Medicaid or Medicare.
- Familiar with medical terminology
- Experience in customer engagement or customer service.
- Bilingual in English and Spanish is preferred.
Equivalent Education and/or Experience -
May have an equivalent combination of education and experience to substitute for the education or experience requirements.
Skills or Special Abilities
- Must be detail oriented, possess basic mathematical skills and have good analytical skills to resolve financial issues.
- Able to prioritize, be flexible and well organized.
- Able to read and utilize reports and tracking tools.
- Ability to use basic problem-solving skills
- Follows Federal (SSI) and Texas Medicaid regulations.
- Ability to quickly adapt to various software systems including QNXT, CCA, TexMedConnect TIERS, etc.
- Knowledge of the cultural and socioeconomic issues related to health and disabilities.
- Knowledge of childrens programs, such as Medicaid, CSHCN, CPW, CPS/Foster Care, SSI, NBS, NBHS, Lead, Early Childhood Intervention (ECI), and CHIP
- Skilled in conflict resolution, mediation, and problem solving.
- Proficient in the use of Microsoft Word, Excel, and Power Point.
- May travel 25% of the time.
- Works in tandem and supports the Care and Utilization Management Departments in identifying and enrolling members in the SSI program.
- Gathers necessary documents and evidence to support proof of eligibility / disability for potential SSI eligible members and files applications for public benefits for individual clients.
- Performs follow up with members and Social Security Administration (SSA) regarding SSI interview date, to ensure all appointments are set up and communicated.
- Functions as the memberÂ¿s Public Benefits Advocate (PBA) assisting the member at the initial SSI interview, appeals any denials, represents member at administrative hearings when required, and negotiates with the appropriate administrative agency as the members representative in order to secure maximum benefits. Accompanies member to interview and arranges for member transportation if needed.
- Assures that all needed documentation is submitted in a timely manner to SSA. Ensures that the member and/ or agency has submitted documentation to the appropriate resources as needed
- Maintains SSI database records appropriately, including filing information, and creating activity reports in order to ensure reliable data is available.
- Maintains proper SSI filed cases arranged in a manner consistent with departmental policy. Responsible for initiating paper files, electron files, completing computer entry forms, maintain own computer database and managing own caseload workflow.
- Monitors membership database to ensure that members who obtain Social Security Income are converted to the appropriate Medicaid type program and provide regular status reports.
1. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP.
2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding.
Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.
Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth
Job Segment: Medical, Patient Care, Medicaid, Medicare, Healthcare Administration, Healthcare