Entitlements Specialist

VIP Community Services; New York (NY); On-site; USD 52,000 - 64,000; Full time

Job summary

VIP Community Services in New York, NY seeks an Entitlements Specialist to manage Medicaid/Intake applications, follow up on HRA processes, and coordinate pending Medicaid and SSI/Fair Hearing activities. You will help ensure timely enrollment and ongoing eligibility for clients.

The role involves counseling on benefits, tracking recertifications, and arranging HRA interviews, with a focus on accuracy, timeliness, and client advocacy. Proficiency in Spanish is a plus.

Qualifications

• Associate Degree or High School Diploma.
• Minimum of 3 years experience in the behavioral health entitlements field.
• CAC/Navigator certification is a plus.
• Bilingual English/Spanish preferred.
• Excellent written and oral communication skills.
• Knowledge of computer programs.
• Excellent organizational skills.

Responsibilities

• Complete Medicaid/Intake applications for new and returning clients, and follow up for NY Health Exchange enrollment.
• Provide Entitlements Counseling to ensure active benefits and guide through eligibility and spend down status.
• Monitor recertified cases and report to Program Directors weekly.
• Complete HRA Entitlements package for Level II Congregate Care and deliver to HRA within 48 hours.
• Schedule HRA interview appointments for new admissions.
• Assess client eligibility for Self Pay status when applicable.
• Attend mandatory trainings and meetings as assigned.

Skills

Bilingual English/Spanish

Excellent communication skills

Strong organizational skills

Computer proficiency

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.