Benefits Specialist in Suffolk

Western Tidewater Community Service Board welcomes you to join our team!

At WTCSB our mission is to provide a coordinated system of quality recovery-oriented care in Mental Health, Intellectual Disability, and Substance Abuse Services to the citizens of the cities of Franklin and Suffolk and the counties of Isle of Wight and Southampton. We continually strive to value staff, support diversity, and promote excellence and personal choice in the provision of consumer care.

We are seeking a Benefits Navigator!

The Benefits Specialist assists individuals receiving services through WTCSB with obtaining, maintaining, and restoring Medicaid and other health insurance benefits. This position works collaboratively with individuals, Case Managers, Finance, supervisors, DSS, and other community partners to address eligibility concerns and help prevent interruptions in coverage.

Maintain & Restore Benefits

• Assist individuals with Medicaid applications, renewals, reinstatements, and spenddown requirements.
• Monitor Lost, Limited, Pending, and Spenddown Medicaid and provide appropriate follow-up.
• Assist individuals with understanding eligibility requirements and required documentation.
• Help identify other available insurance and benefit resources, including Medicaid, Medicare, and commercial insurance.

Coordinate & Follow Up

• Collaborate with Case Managers, Finance, supervisors, DSS, and other community partners to resolve benefits-related issues.
• Follow up on applications, renewals, eligibility concerns, and barriers to obtaining or maintaining coverage.
• Provide education and support to individuals and staff regarding Medicaid eligibility and benefits processes.
• Communicate concerns and coordinate appropriate action when additional assistance or escalation is needed.

Track & Prevent Coverage Gaps

• Monitor eligibility and renewal deadlines to help prevent interruptions in coverage.
• Maintain accurate documentation of benefits-related activities, eligibility status, and outcomes in Credible and other designated systems.
• Track cases and follow-up activities to ensure timely resolution of benefits-related concerns.
• Identify barriers affecting eligibility or continuity of coverage and communicate concerns to agency leadership.

Qualifications and Skills:

• Associate's degree in Human Services, Social Work, Business Administration, Healthcare Administration, or a related field preferred.
• Experience with Medicaid, Medicare, health insurance, public benefits, or eligibility programs preferred.
• Experience working with individuals with mental health, substance use, intellectual disability, or related needs preferred.
• Knowledge of Virginia Medicaid eligibility and application processes preferred.
• Strong organizational, communication, problem-solving, and documentation skills.
• Ability to manage multiple cases, deadlines, and follow-up requirements.
• Ability to work independently and collaborate effectively with individuals, families, agency staff, DSS, and community partners.
• Ability to maintain confidentiality and handle sensitive information appropriately.
• Basic computer skills and ability to learn electronic health record and benefits-tracking systems.
• Must possess a valid Driver's License with an acceptable DMV record.

Benefits for Full-Time:

· Health Insurance/Life Insurance

· Virginia Retirement System plan

· Flexible Spending Account (FSA)

· Vacation/Sick leave/Holiday pay

· Legal Resources

· VA529-Tuition Savings

· Critical & Accidental Insurance

· Tuition discount-South University

· Aflac

· Working Advantage – shopping discount

To Apply:

Submit a cover letter and resume via Indeed, or on our job board at www.wtcsb.org. ONLY THOSE APPLICANTS SELECTED FOR AN INTERVIEW WILL BE CONTACTED. WTCSB is a drug, alcohol & smoke free workplace. Visit our website, www.wtcsb.org for more information or email employment@wtcsb.org .

WTCSB is an equal opportunity employer

#INDHP