Eligibility Specialist

Volunteers of America National Services (VOANS)•Louisville, KY

1d•$47,000 - $54,000•Onsite

About The Position

Senior Community Care of Kentucky PACE is hiring an Eligibility Specialist in Louisville, Kentucky. Under the supervision of the Marketing Manager/Enrollment Supervisor, this role obtains initial admissions information, coordinates intake, provides information and referrals to community agencies as appropriate, supports the enrollment team with eligibility, and promotes the program to potential participants and community agencies. The specialist works with participants and internal teams to establish and maintain eligibility for Medicaid and other public assistance programs. Responsibilities include supporting applications and recertifications, ensuring compliance with applicable State Medicaid rules for Long Term Care Medicaid, monitoring eligibility and financial responsibility, and preparing data and reports according to CMS or program requirements.

Requirements

Medical clearance for communicable diseases and up-to-date immunizations before direct participant contact.
Valid driver’s license and access to transportation.
Must clear a background check.
Bachelor’s degree in a health and human services field or equivalent four years of experience related to public benefits.
Two years of experience in case work for public assistance programs or in an information and referral resource role within senior services.
Familiarity with benefits available to older adults.
Training or related experience in the assigned job.

Responsibilities

Gather necessary documentation and application requirements with the Enrollment Specialist to support participants seeking Medicaid approval.
Ensure compliance with State Medicaid rules and regulations pertaining to Long Term Care Medicaid.
Assist participants with applications for SNAP and other state-specific Medicaid or public assistance programs for which they may be eligible.
Track private-pay and Medicare-only clients and help facilitate a smooth transition to Medicaid eligibility.
Ensure appropriate forms are completed and participants understand their financial responsibility when they are not eligible for Medicare or Medicaid.
Work with the Health Plan Operations Team and Executive Director to track and monitor the A/R Aging report and collect outstanding debts.
Review and monitor eligibility reports from the Health Plan Operations Team and support participants who lose benefits in re-establishing eligibility.
Guide participants through the financial eligibility process and help them gather and submit supplemental documents required to establish benefit eligibility.
Educate applicants, recipients, and the general public about program regulations and other pertinent material.
Review participants’ Medicaid eligibility, monitor recertification time frames, and facilitate Medicaid certification and recertification applications using the state-specific process.
Collect data and prepare reports in accordance with CMS or program requirements.
Obtain initial admissions information, coordinate intake, provide information and referrals to community agencies as appropriate, support enrollment eligibility, and promote the program to potential participants and community agencies.