Menumenu

Eligibility Specialist

The Eligibility Specialist will assess whether our clients qualify for various financial aid programs from the government. This includes working with Medicare, Medicaid, disability claims or other government sponsored programs. This role acts as an informational resource for our clients and their families. Successful candidates will have experience in Medicaid eligibility in a health care setting.

Responsibilities:

  • Monitor all DSS, SSA/SSI funding and complete monthly reports
  • Provide education to the potential individuals and their families regarding the Medicaid process, and determine Medicaid eligibility
  • Facilitate compilation of all required documents to be submitted to the State within specified time-frame to assure Medicaid coverage for individual
  • Track and follow the Medicaid status for all new enrollees
  • Take a lead role in SSI/SSA audits and Medicaid audits
  • Revalidate individuals Medicaid benefit when current Medicaid participant's coverage expires
  • Maintain spreadsheet to track all client wages, DSS, SSA and SSI income on a monthly basis
  • Investigate missing checks by contacting agency workers
  • Resolve payment errors with DSS and Social Security
  • Complete and distribute all DSS redeterminations in a timely manner
  • Assist Directors with completion of SS Continuing Disability reviews, Redeterminations, and Disability Update reports
  • Complete Representative Payee reports filed with Social Security and all other Social Security reports in a timely manner
  • Insure that clients are invoiced the proper amounts for medical supplies, according to DDS rules
  • Report all changes in client status to DSS workers, W-265’s, etc.
  • Maintain comprehensive client files including all documentation relating to client funding
  • Follow up on Medicaid and Medicare benefit issues with caseworkers
  • Complete monthly Personal Fund reports for personal fund checks. Insure that clients are receiving proper amounts
  • Review and submit DDS and EDS Attendance Reports on a monthly basis and input attendance data on 4510 worksheet

Qualifications:

  • Minimum 3 years of experience with Medicaid and Medicare Eligibility procedures
  • Minimum of 3 -5 years of Social Work/bookkeeping/accounting experience
  • Experience with WBRESDAY a plus
  • Computer familiarity, including a working knowledge of Microsoft Windows, Excel and Word, and the flexibility to learn and work with other computer programs required
  • Bachelor's Degree from an accredited college or university, with a social work and/or business management

Please send your resume and salary requirements to: This email address is being protected from spambots. You need JavaScript enabled to view it.

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