Health Benefits Information Specialist

New York City is home to approximately 1.8 million older adults, and the Department for the Aging is committed to helping them age in their homes and communities. Our mission is to eliminate ageism and ensure the dignity and quality of life of diverse older adults. We also work to support caregivers through service, advocacy, and education.

The Health Insurance Information Counseling and Assistance Program (HIICAP) helps older adults navigate the complexities of all components of Medicare. HIICAP conducts public outreach presentations and workshops to older adults, community partners, and other groups on Medicare, Medicaid, Medigap, Elderly Pharmaceutical Insurance Coverage (EPIC), and Medicare’s preventive services. New York State certified counselors provide assistance with Medicare Part D prescription plan selection, Medicare Savings Programs, and enrollment by appointment and via telephone, among other services. In addition, HIICAP has 7 community-based sites citywide that offer direct assistance in 15 different languages. HIICAP also received the NYC Top Performer award from the NY. The mission of HIICAP is to promote the independence, health, and dignity of older adults through direct support, education, and advocacy.

NYC Aging's HIICAP unit is seeking a dynamic individual to join our team as a Health Benefits Information Specialist. In this role, you will be tasked to provide invaluable support to Medicare beneficiaries but also lead outreach initiatives to educate and empower our community.

The Health Benefits Information Specialist plays a key role in assisting Medicare beneficiaries by providing accurate, unbiased information regarding Medicare Advantage plans. This position is responsible for guiding individuals who are enrolled in or considering enrollment in Medicare Advantage plans, helping them understand their options, benefits, and limitations. The role does not involve enrolling individuals in any plan but focuses on delivering educational support to empower beneficiaries to make informed decisions.
The responsibilities of the position include, but are not limited to:

Medicare Advantage Counseling:

• Provide clear, comprehensive information about Medicare Advantage plans to beneficiaries and their families.
• Conduct one-on-one counseling sessions with beneficiaries to answer questions and clarify Medicare Advantage plan specifics.

Appeals and Grievances Support:

• Assist beneficiaries in understanding their rights, protections, and any limitations or potential issues related to Medicare Advantage plans.
• Stay updated on Medicare Advantage regulations, policy changes, and plan offerings to provide the most current information.

Special Enrollment Period (SEP) Assistance:

• Educate beneficiaries about Special Enrollment Periods (SEPs), that qualify them for enrollment or plan changes outside of the Annual Enrollment Period.
• Assist beneficiaries in gathering required documentation and facilitate timely enrollment during SEPs.

Fraud and Abuse Prevention and Reporting:

• Provide education to beneficiaries on how to detect and report Medicare fraud and abuse, such as deceptive marketing practices or fraudulent billing.
• Work with the Senior Medicare Patrol (SMP) to assist in identifying and reporting potential fraud or abuse cases to the appropriate authorities.

Collaboration and Training:

• Collaborate with other HIICAP team members, local agencies, and community organizations to share knowledge and improve services.
• Participate in ongoing training on Medicare Advantage plans, policies, and relevant Medicare regulations.