Job: Member Benefits Specialist

Collaborates with providers to assure that CPSA identifies and reports all sources of payment for CPSA services, including state and federal benefits, third party payers, and other insurance coverage. Implements and coordinates structure of benefits, entitlement and changes which has direct impact on providers. Trains and advises provider Intake/Member Benefits staff to ensure compliance with federal, state and CPSA coordination of benefits policies and procedures. Under general supervision, reviews medical records to ensure the financial documentation obtained in the medical records is in accordance with CPSA/ADHS/DBHS guidelines, and justifies the data for potential Title XIX/XXI members.

Associate’s Degree or equivalent education and experience plus three years in the behavioral health field OR; Bachelor’s Degree or equivalent education and experience plus one year in the behavioral health field. Proficiencies in Microsoft Word and Excel applications, interviewing applicants, and determining eligibility for Federal, State and County financial and medical public assistance entitlement programs are required. Experience in coordinating and implementing program training is also required.

Strong communication skills highly desired. Experience in reviewing and monitoring healthcare records preferred. Must have a valid Arizona Driver’s License and an insured vehicle. Must be able to obtain full fingerprint certification