Entitlements Specialist

Vocational Instruction Project; New York (NY); On-site; USD 45,000 - 65,000; Full time

Job summary

Vocational Instruction Project seeks an Entitlements Specialist to manage Medicaid/Intake applications and HRA processes for new and existing clients. You will determine eligibility, assist with recertification, and ensure timely enrollment or disenrollment in managed care.

The role involves counseling clients on entitlements, gathering required documents, and coordinating with admissions and program directors.

Qualifications

• Requires strong written and verbal communication skills.
• Experience in behavioral health entitlements is preferred.
• Proficiency with computer programs and case management systems.”

Responsibilities

• Process Medicaid/Intake applications for new and renewed clients.
• Determine eligibility and assist with EPACES and HRA processes.
• Schedule and manage HRA interview appointments for admissions.
• Prepare and deliver HRA packages to Human Resources Administration within 48 hours.
• Assess eligibility for Self Pay status when applicable.

Skills

Excellent communication

Bilingual English/Spanish

Organizational skills

Computer literacy

Education

Associate Degree or High School Diploma

Job description

Description

Job Title: Entitlements Specialist

Reports to: Admission Director

POSITION SUMMARY: 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.

Position Description

A. ENTITLEMENTS:

• Responsible for Medicaid/Intake Applications for new clients and re-application for those clients who have lost Medicaid Benefits. This includes collecting the required documents from the clients needed to complete the application through the NY Health Exchange.
• Provide Entitlements Counseling for all clients of VIP to ensure active benefits, including Eligibility, Restrictions, Spend Down status, Managed Care disenrollment/enrollment, and guidance towards recertification. Determine client eligibility through EPACES for all new admissions.
• Monitor recertified cases for eligibility status and report to Program Directors on a weekly basis.
• Completion of HRA Entitlements package for Level ll Congregate Care (mandated and non-mandated, SSI/SSD recipients).
• Responsible for making HRA interview appointments for all new residential admissions.
• Responsible for delivery of HRA package to the Human Resource Administration within 48 hours of completion.
• Assess client eligibility for Self Pay status if applicable.

B. Participate in Job Trainings and Education Programs, Meetings and Committees as assigned or indicated.

• Attend mandatory in-service trainings as scheduled.
• Attend seminars to further professional development

Requirements

JOB COMPETENCY:

• 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.