Entitlement Specialist Medicaid Liason -ED534817

ICL•New York, NY

About The Position

The Entitlement Specialist / Medicaid Liaison Coordinator takes direction from the Entitlement Services Supervisor Medicaid and Medicare cases and supports in the carrying out of assignments that include the processing, maintenance, and completion of various job tasks and responsibilities. This role involves representing Medicaid consumers’ cases, assisting with Medicaid case preparation, resolving Medicaid issues, researching and understanding complex Medicaid rules and regulations, and ensuring compliance with Medicaid requirements. The Specialist also attends Medicaid meetings and trainings, maintains client case records, manages monthly entitlement account records, stays updated on entitlement benefits, collaborates with various ICL departments, develops collateral agency contacts, provides entitlement counseling, and participates in supervisory and benefits trainings.

Requirements

Excellent verbal and written communication skills.
Developed computer literacy.
Knowledge of Medicaid and Managed Care guidelines.
Ability to design forms for the collection of information.
Highly organized and detail oriented.
Ability to complete tasks in a timely manner.
Ability to identify problem and analyze.
Ability to multitask, prioritize work, and perform under stress.
Willingness to expand knowledge base.
Positive attitude and excellent customer service skills.
Bachelor’s degree (B.A.) plus 2 years’ experience in social/human services (providing services to individuals with psychiatric disabilities a plus), entitlement or related area of service, OR Associate degree plus 3 years of above experience, OR High School diploma/G.E.D. plus 4 years of above experience.

Nice To Haves

Providing services to individuals with psychiatric disabilities is a plus.

Responsibilities

Represents Medicaid consumers’ cases at the Clients’ Representative Unit at Medicaid office.
Assists Entitlements Specialists in preparation of consumers’ Medicaid cases for processing at Medicaid office.
Follows up cases at Medicaid office either via phone or in person until Medicaid issue is resolved.
Researches and learns the complex rules and regulations of operation of various Units within Medicaid system and delivers this information to the Entitlements Department.
Assists Entitlements Specialists in navigating the Medicaid complex system to ensure compliance with requirements of Medicaid, Medicaid HMO plans including enrollment into Behavioral Health Managed Care Organizations (BHO), Surplus, MSP, and Medicaid Buy-in Programs.
Attends by-monthly Medicaid Citywide meetings and makes the Entitlements Department aware about discussed issues.
Attends Medicaid trainings.
Is able to utilize any type of resources in order to prepare presentations for consumers and clinical staff.
Maintains Entitlement client case records in a timely and accurate manner – the up-to-date filing of all incoming entitlement correspondence, inter- and intra-agency documents and information documents relating to the resident’s entitlement case.
Maintains an up-to-date and accurate written record, in the Contact Notes section of the client case record, of all Entitlement interactions with residents, and with all the entitlement systems, and inter- and intra-agency contacts pertaining to the resident’s entitlement case.
Utilizes the Entitlement case record as an analytical tool to be able to efficiently access entitlement information when problems arise and for other purposes, e.g., statistical surveys, departmental reports, etc., and can use this resource to problem solve and to present this information for supervisory review.
Archives hard-copy files in compliance with records retention policies.
Maintains all additional ICL Entitlement forms and procedures that may be developed to enhance the full range of maintenance of case records task.
Maintains an accurate and up-to-date monthly Entitlements programs’ Benefits Amounts spreadsheets.
Utilizes this account record as an analytical oversight tool to ensure ongoing receipt of client eligible entitlement funds and to monitor the flow of client entitlement funds.
Maintains accurate and up-to-date Direct Deposit records of SSA eligible consumers.
Responsible for timely processing all necessary paperwork for opening and closing Direct Deposit.
Scans all copies of the prior month entitlement checks into Entitlements folder.
Maintains all additional ICL forms and procedures that may be developed to enhance these recording and analytical tasks.
Is familiar with and able to readily use The Public Benefits Research Center (PBRC) Manual.
Can utilize and integrate any new entitlements information accessed using electronic and other media.
Can utilize any type of resources to prepare presentations for consumers and clinical staff.
Maintains the electronic data system and uses e-mail service daily.
Can read and understand the regularly ICL - issued reports and is able to integrate the reported information into his or her ongoing case management activities.
Can analyze Finance reports, research individual consumer’s information, and determine further actions.
Maintains an on-going contacts with other ICL Departments, programs’ staff, clinical managers and doctors to maintain accurate and up-to-date clients’ case management activities.
Access, develop and maintain collateral agency contacts and relationships to better process entitlement information and documents to maximize the resident’s entitlement benefits.
Utilize these collateral agency contacts as an on-going resource for additional entitlement knowledge and as a means of expanding and enhancing the Specialist’s advocacy skills.
Communicate in an effective manner, both orally and in writing, with wide range of collateral agencies to initiate, maximize and continue the resident’s entitlement benefits and services.
Be able to effectively communicate with the highest level of collateral staffs such as: AA to the Director, Supervisor or Manager to ensure the clients’ benefits cases are processed timely and in an efficient manner.
Serve as a client advocate in front of SSA court and at PA, Medicaid and SNAP Fair Hearings.
Collect and process all medical documentation and forms used to help ICL consumers during their Hearings.
Maintain all additional ICL Entitlement forms and procedures that may be developed to enhance these collateral contact tasks.
Maintain scheduled Entitlement counseling meetings for the purpose of providing entitlement outreach and advisement to both residents and staff.
Provide individualized benefits advisement services to consumers, which includes collecting the data, analysis and a recommendation to the individual.
Can communicate effectively and sensitively with both residents and staff and is particularly attuned to the resident’s varied and changing abilities to process the often difficult and complex entitlement information.
Maintain all additional ICL Entitlement forms and procedures that may be developed to enhance these counseling and reporting tasks.
Actively participate in the supervisory process.
Can utilize supervision by taking direction regarding the daily processing and completion of assigned departmental tasks.
Through trainings, enhance and expand entitlement knowledge and the skills necessary to effectively work with residents, agency staffs and the various benefit systems.
Attend various benefits training sessions, be able to understand and comprehend the ever-changing Entitlements operation procedures, relay the subsequent information to the co-workers and utilize it in Specialist’ day-to-day work.
Make reasonable judgments as to which tasks should be completed sooner rather than later.
Organize a paperwork and case management triage system and process for themselves that will not jeopardize either a resident’s entitlement benefits, or the entitlement revenue returns to the agency.