Entitlements Specialist
About The Position
Under the direction and supervision of the Admission Director, the Entitlements Specialist is responsible for completion of Medicaid/Intake applications, follow-up for Human Resources Administration (HRA) applications and Pending Medicaid, SSI/Fair Hearing appointments and Managed Care (HMO) dis-enrollments. This role involves collecting required documents, providing counseling on benefits, determining client eligibility, monitoring cases, completing HRA packages, scheduling HRA interviews, and assessing client eligibility for Self Pay status. The specialist will also participate in job trainings, education programs, meetings, and committees as assigned, including attending mandatory in-service trainings and seminars for professional development.
Requirements
- Associate Degree or High School Diploma
- Minimum of 3 years experience working in the behavioral health field in the Entitlements Sector.
- CAC/Navigator certification a plus.
- Bilingual English/Spanish Preferred
- Excellent written and oral communication skills.
- Knowledge of computer programs.
- Excellent organizational skills.
Nice To Haves
- CAC/Navigator certification
- Bilingual English/Spanish
Responsibilities
- Completion of Medicaid/Intake applications for new clients and re-application for clients who have lost Medicaid Benefits.
- Collecting required documents from clients to complete applications through the NY Health Exchange.
- Providing Entitlements Counseling for all clients to ensure active benefits, including Eligibility, Restrictions, Spend Down status, Managed Care disenrollment/enrollment, and guidance towards recertification.
- Determining client eligibility through EPACES for all new admissions.
- Monitoring recertified cases for eligibility status and reporting to Program Directors on a weekly basis.
- Completion of HRA Entitlements package for Level ll Congregate Care (mandated and non-mandated, SSI/SSD recipients).
- Making HRA interview appointments for all new residential admissions.
- Delivery of HRA package to the Human Resource Administration within 48 hours of completion.
- Assessing client eligibility for Self Pay status if applicable.
- Participating in Job Trainings and Education Programs, Meetings and Committees as assigned or indicated.
- Attending mandatory in-service trainings as scheduled.
- Attending seminars to further professional development.
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What This Job Offers
Career Level
Mid Level
Education Level
Associate degree
