Benefits Specialist

About the role

Maintain a working relationship with the Department of Social Service (DSS), Human Resources Administration (HRA), Social Security Administration (SSA), Medicaid Office, NYS Office of Temporary and Disability Assistance to obtain appropriate funding.

To ensure that all funding guidelines, policies, and procedures are followed.

Responsibilities

• Conduct daily comprehensive review of consumers’ interviews to determine eligibility for Entitlements benefits, Medicaid Eligibility, Medicare, and Managed Care coverage
• Interview new admissions for HRA/DSS/SSI/SSD/Self-Pay/30% scale
• Contact Department of Social Services (DSS), Human Resources Administration (HRA) to schedule initial appointments for the process of clients’ benefits (Room & Board, PNA, SNAP) and Medicaid coverage
• Aid consumers with the completion and submission of Public Assistance recertification, reapplying process, Fair Hearings, Fraud Investigations, SSI/SSD Redeterminations, State change of payee, SNAP recertification, Medicaid renewal and SSDI continuing disability reviews
• Aid consumers obtaining documentations such as Birth Certificates, Social Security card, unemployment/employment verification, documents required for DSS/HRA application processes
• Inform consumers on benefits-related issues and/or other issues that may arise
• Escort consumers to various government and city agencies
• Navigate Epaces (eMedNY) / Inovalon / STARS / SAAMS / AWARDS / WTW / Manage Care System Portals for coverage
• Report changes on STARS (Transfers/LACA/Discharges/Program Complete)
• Update SAAMS / Westchester weekly attendance / monthly Progress Reports (Orange, Rockland, Nassau, Suffolk Counties)
• Maintain up-to-date files with approvals, budget, and award letters from the Human Resources Administration (HRA), Social Security Administration (SSA), State Department of Social Services (DSS), Self-Pay and 30% agreements calculations
• Daily communication with facilities to verify residents’ HRA two-part phone calls appointments interviews, Social Security change of payee process, and follow up on missed appointments
• Entitlement Reports: Monthly Database update with consumers’ benefits
• AWARDS update with Medicaid/Medicare/Private Insurance
• Westchester monthly Progress Reports
• Maintain a filing system in place for Entitlement active and inactive charts for 7 years.

Requirements

• BA Degree preferred in Human Services or related field
• Knowledgeable with HRA/DSS, SSA, Self-Pay, 30% working client scale
• Background with DSS/HRA recertifications, Medicare, Medicaid managed care
• Demonstrated effective communication, proficiency in Excel, computer skills, organization and multitasking
• Notary Public Stamp