Takes direction from the Entitlement Services supervisory/management staff in the carrying out of entitlement and/or Medicaid/Medicaid HMO case management tasks for ICL HEALTH HOMES population. In the process of case managing consumers' Medicaid/Medicaid HMO eligibility Entitlements Specialist will engage in the following specific tasks
MAINTAINS OF MEDICAL INSURANC CASE RECORDS:
Maintains an up-to-date and accurate written record of all Entitlement interactions with consumers, and with all the entitlement systems, and inter- and intra-agency contacts pertaining to the consumer’s entitlement case.
Maintains an up-to-date filing in the Consumers’ Case records of all copies of the consumer's benefits correspondence including medical insurance records, financial resource documents and releases and copies of all IDs.
Utilizes the consumers’ benefits case record as an analytical tool in order to access benefits/medical insurance information when problems arise and as information and resource tool for the purposes of assisting the consumer with benefits. The Entitlements Specialist will also utilize this case record as a resource for supervisory review.
Maintains any and all additional ICL Health Home benefits/medical insurance forms and procedures that may be developed to enhance the full range of maintenance of case records task.
The Entitlements Specialist is fluent in the use of the major entitlement benefit web sites in order to access and research specific entitlement benefits and Medicaid HMO information.
The Entitlements Specialist is familiar with and able to readily use The Public Benefits Research Center (PBRC) Manual as a research tool in order to access New York State entitlement benefits and location information in the ongoing management of his or her consumer cases.
The Entitlements Specialist is able to utilize and integrate any new entitlements information a such as POMS – the collection of SSA rules and regulations, HRA Policy Directives in his or her ongoing case management activities.
The Entitlements Specialist is able to utilize any type of resources in order to prepare presentations for consumers and clinical staff.
Maintains the electronic data system and uses e-mail service on a daily basis.
Bachelor’s degree (B.A.) plus 4 years experience in social/human services (providing services to individuals with psychiatric disabilities a plus), entitlement or related area of service, or Associate degree plus 5 years of above experience.
Must demonstrate excellent verbal and written communication skills along with developed computer literacy and excellent organizational skills.
Must have a valid driver’s license.