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Medical Benefits Specialist

Job Title
Medical Benefits Specialist
Chicago,  IL 60606
Other Location

Medical Benefits Specialist

AIDS Foundation Chicago (AFC) mobilizes communities to create equity and justice for people living with and vulnerable to HIV or chronic conditions. We envision a world in which people living with HIV or chronic conditions will thrive, and there will be no new HIV cases. Our work focuses on advancing health equity, preventing new cases of HIV, serving as a collaboration and knowledge center, being a bold voice for change and strengthening our organizational excellence.

We are seeking a motivated and reliable person to serve as a Medical Benefits Specialist. The Medical Benefit Specialist (MBS) is responsible for enrolling eligible Illinoisans receiving Ryan White services in the Cook and Collar Counties, into qualified health plans through the Illinois Health Marketplace, insurance companies, Medicaid, Medicare as well as providing assistance with ADAP benefits. The MBS will be required to complete up to 30 hours of training to obtain consumer assistance certification and will be required to recertify on an annual basis at the federal and state level. The MBS will be required to assist clients with submitting payment requests for HIV related out of pocket costs and copays related to their health insurance, as well as educate case managers and clients on how to navigate their insurance benefits. During low insurance enrollment periods, MBS will provide other supportive direct client services as needed.

Principal functions and responsibilities of this position include the following:

 Client Benefits Enrollments

  • Coordinate efforts with Ryan White-funded agencies to identify individuals to be enrolled in health insurance programs;
  • Screen clients for eligibility for Medicaid, Medicare, Health Insurance Marketplace (HIM);
  • Assist individuals in understanding HIM plans, managed care options for which they are eligible;
  • Enroll clients in the appropriate insurance plan they select;
  • Assist clients with submitting payment requests for HIV related out of pocket costs and copays;
  • Respond to technical assistance requests in a timely manner using AFC’s internal ticketing system;

Client Service Coordination

  • Refer clients to appropriate services highlighted in assessments
  • Refer clients to more intensive case management services if needed;
  • Refer clients to other core and supportive services if determined to be necessary;
  • Complete emergency housing applications for eligible clients;
  • Travel to meet clients at home, clinical, or community based setting as needed;
  • Distribute food vouchers and transportation cards according to eligibility and need and document in the client database.
  • Complete Medication Assistance Program (MAP) applications;                                              

Training Coordination and Resource Assistance

  • Arrange and conduct in-reach and outreach activities, including trainings for case managers and clients regarding Marketplace, Medicaid and or CHIP (Continuous Health Insurance Plans) in Cook and Collar Regions;
  • Function as a resource to case managers and consumers by providing information, assistance and referrals, and taking complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies.


  • Maintain knowledge and expertise by attend trainings and continuing education related to insurance programs as required by AFC including the case management competencies training;
  • Demonstrate cultural competency when working with clients who may be HIV+, LGBT, homeless, indigent, substance users, mentally ill, non-English speaking, or otherwise marginalized and/or underserved;
  • Ensure the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner, according to the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA);
  • Attend all Care Team and AFC-mandated meetings;
  • Attend and assist with agency-wide events and activities as directed;
  • Perform other duties as assigned.


Minimum Qualifications

High School Diploma and 1 plus year’s experience in Case Management and or Public Benefit Screening Experience


The ability to work non-traditional hours including evenings and weekends.

Preferred Qualifications

High School Diploma and 1 plus year’s experience in Case Management and or Public Benefit Screening Experience


The ability to work non-traditional hours including evenings and weekends.


 Strong attention to detail skill and able to multi-task while ensuring that work activities are completed accurately, efficiently and in a timely manner.

Solid verbal/written communication skills as well as strong interpersonal skills and the ability to build relationships to identify client’s/customer’s needs.

Strong ability to provide efficient, quality service to both internal and external customers.  This includes putting the customer first, following through on responsibilities, ensuring that promised work is completed, taking responsibility for commitments.

Diversity Awareness and the ability and willingness to respect and value the differences and perceptions of different groups/individuals. 

Strong ability to use various Microsoft Office applications, specifically Excel and/or other database programs in order to perform job duties such as generating basic reports using these programs.

Please reference position PRG MBS 800

Decisions and criteria governing the employment relationship with all employees at AIDS Foundation of Chicago are made in a non-discriminatory manner, without regard to race, ethnicity, creed, religion, color, sex, sexual orientation, gender identity or expression, age, national origin, citizenship status, military service and/or marital status, order of protection status, handicap, disability (including HIV/AIDS status), or any other factor determined to be unlawful by federal, state, or local statutes.


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