Entitlement Specialist

Odyssey House INC•New York, NY

17h•Onsite

About The Position

Since 1967, Odyssey House has gone beyond helping individuals beat drugs and alcohol. We help rebuild lives. There’s more to recovery than just getting clean. We help individuals get healthy again, too, with medical and dental care, fitness programs, support for your mental health and more. Individuals can stay with their children while in treatment, while learning new life skills, so they can stay together and repair other broken relationships in their lives. We provide educational and work skill trainings, outpatient services and available housing assistance, so individuals can step back into real life with a real future. If that sounds different than other treatment programs, you’re right. Because Odyssey is where recovery gets real. MAJOR FUNCTIONS: Maintain a working relationship with the Department of Social Service (DSS), Human Resources Administration (HRA), Social Security Administration (SSA), Medicaid Office, NYS Office of Temporary and Disability Assistance to obtain appropriate funding. To ensure that all funding guidelines, policies, and procedures are follow.

Requirements

BA Degree preferred in Human Services or related field
Knowledgeable with HRA/DSS, SSA, Self-Pay, 30% working client scale
Background with DSS/HRA recertifications, Medicare, Medicaid managed care
Demonstrated effective communication, proficiency in Excel, computer skills, organization and multitasking
Notary Public Stamp

Responsibilities

Conduct daily comprehensive review of consumers’ interviews to determine eligible for Entitlements benefits, Medicaid Eligibility, Medicare, and Managed Care coverage
Interviews new admission for HRA/DSS/SSI/SSD/Self-Pay/30% scale
Contact Department of Social Services (DSS), Human Resources Administration (HRA) to schedule initial appointments for the process of clients’ benefits (Room & Board, PNA, SNAP) and Medicaid coverage
Assist consumers with the completion and submission of Public Assistance recertification, reapplying process, Fair Hearings, Fraud Investigations, SSI/SSD Redeterminations, State change of payee, SNAP recertification, Medicaid renewal and SSDI continuing disability reviews
Assist consumers obtaining documentations such as Birth Certificates, Social Security card, unemployment/employment verification, documents required for DSS/HRA application processes
Educate consumers on benefits-related issues and/or other issues that may arise
Escort consumers to various government and city agencies
Navigate Epaces (eMedNY) / Inovalon / STARS / SAAMS / AWARDS / WTW / Manage Care System Portals for coverage
Report changes on STARS (Transfers/LACA/Discharges/Program Complete)
Update SAAMS / Westchester weekly attendance / monthly Progress Reports (Orange, Rockland, Nassau, Suffolk Counties)
Maintain up-to-date files with approvals, budget, and award letters from the Human Resources Administration (HRA), Social Security Administration (SSA), State Department of Social Services (DSS), Self-Pay and 30% agreements calculations
Daily communication with facilities to verify residents’ HRA two-part phone calls appointments interviews, Social Security change of payee process, and follow up on missed appointments
Entitlement Reports: o Monthly Database update with consumers’ benefits o AWARDS update with Medicaid/Medicare/Private Insurance o Westchester monthly Progress Reports
Maintain a filing system in place for Entitlement active and inactive charts for 7 years.
Other relevant duties as assigned