ENROLLMENT SPECIALIST

Ohio District 5 Agency On Aging•Ontario, OH

About The Position

This position is established for the purpose of facilitating enrollment of individuals onto the PASSPORT and Assisted Living Waivers. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

Knowledgeable in Microsoft Word and Excel.
Ability to communicate professionally, respectfully and effectively.
Ability to prioritize, organize and maintain accuracy in a flexible job environment.
Ability to make sound decisions and demonstrate critical thinking skills.
Ability to relate well with all individuals, community agencies, and Area Agency staff.
Embraces and exemplifies the Agency’s 4 Keys of Excellence: Safety, Customer Service, Courtesy, Efficiency.
Must maintain strict confidentiality and comply with all Agency HIPAA policies and procedures.
Ability to travel.

Responsibilities

Facilitates enrollment of individuals onto PP or AL waiver by monitoring Medicaid application status and working with individual/representative to remove barriers.
Maintains pending applicant tracking log.
Utilizes Ohio Benefits, MITS, PNM applications to obtain and share eligibility status updates. Also, networks with JFS caseworker and individual/caregiver to document update on application status and reason(s) for pending in PIMS every 15 days.
Networks with doctor offices and tracks obtaining PCP approval of waiver and LOC.
Completes Next Step phone call and template with the individual/representative within 5 business days of receiving assessment information.
Completes ODA required contact with pending Medicaid enrollment individual/representative every 30 days.
Coordinates with hospitals, nursing facilities, assisted Living facilities, managed care entities and other AAAs to facilitate transfer and/or enrollment.
Facilitates communication by providing release of information documents and/or assisting with phone calls to community entities to obtain information needed to assist with the enrollment process of individuals including, but not limited to: physician’s offices; banks; insurance companies; and funeral homes.
Makes home visits as needed to assist individuals with application process.
Notifies Compliance Coordinator when an individual is ready for CM assignment and amount of liability if one is assigned by JFS.
Assigns appropriate funding source to individual’s services.
Facilitates individual’s access to Medicaid State Plan or Medicare Skilled Home Care services.
Documents work activities in accordance with the Agency and ODA specifications and time frames in prescribed computer programs, including, but not limited to: PIMS, Access Logs, Ohio Benefits, PNM, Excel; and Word.
Updates, maintains and completes reports and lists as required and within required time frames.
Scans individual records as needed.
Completes special projects and activities as assigned.
Provides back-up support to other Units as needed.
Backs up and assists Medicaid Services Specialists as necessary.
Maintains and promotes positive working relationships among Agency staff and the Aging Network.
Understands the Agency’s Conflict of Interest Policy and complies with the Ohio Aging Network’s requirements for disclosure.
Assists with and completes special projects and activities as assigned.
Participates in training to maintain and improve job skills.
Performs duties with respectful communications & behaviors.