Eligibility Specialist

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

1d•$47,000 - $54,000

About The Position

The Eligibility Specialist oversees both Senior Community Care of Kentucky PACE sites and conducts home visits in Jefferson County. Under the supervision of the Marketing Manager/Enrollment Supervisor, the specialist obtains initial admissions information, coordinates the intake process, 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 role guides participants through financial eligibility processes, including Medicaid certification and recertification, and helps them gather and submit required documentation. It also supports applications for SNAP and other public assistance programs, monitors eligibility and transitions to Medicaid, helps ensure compliance with state Long Term Care Medicaid requirements, and prepares required program and CMS reports. The position requires participant contact and occasional weekend and evening work.

Requirements

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 casework 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.
Valid driver’s license and means of transportation.
Medical clearance for communicable diseases and up-to-date immunizations before direct participant contact.
Successful background check.

Responsibilities

Gather required documentation and application materials with the Enrollment Specialist to support participants’ Medicaid approval.
Ensure compliance with State Medicaid Rules and Regulations related to Long Term Care Medicaid.
Assist participants with applications for SNAP and other applicable state Medicaid or public assistance programs.
Track private-pay and Medicare-only clients and support transitions 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 monitor accounts receivable aging and collect outstanding debts.
Review eligibility reports and support participants who lose benefits in re-establishing eligibility.
Guide participants through financial eligibility processes and help gather and submit supplemental documents required for benefits.
Educate applicants, recipients, and the general public about program regulations and related information.
Act as a provider-authorized representative for participants’ Medicaid benefits; review eligibility, monitor recertification timelines, and facilitate certification and recertification applications through state-specific processes.
Collect data and prepare reports in accordance with CMS and program requirements.
Obtain initial admissions information, coordinate intake, provide information and referrals, support enrollment eligibility, and promote the program to potential participants and community agencies.
Oversee both program sites and conduct home visits in Jefferson County.