Medicaid Eligibility Coordinator

Job Summary:

The Medicaid Eligibility Coordinator is responsible for the execution of strategy related to the benefit access for people eligible for Health Home care management services. This includes Basic Health Home Support as well. The Medicaid Eligibility Coordinator is responsible for conducting routine monitoring and reporting of the eligibility status for members and providing technical support and assistance for members to receive Medicaid enrollment/eligibility and OPWDD HCBS Waiver services. This position is responsible for ensuring compliance and quality standards are met, as well as upholding agency policy and practices.

Essential Duties and Responsibilities:

• Completes all necessary documentation related to Medicaid enrollment, benefit acquisition and maintenance of eligibility.
• Facilitates the completion of Medicaid applications, recertifications and support with processing, submitting, and tracking assigned tasks and follow-up activities as needed. Provides support to the Care Connection team in ensuring the correct type of Medicaid is secured for OPWDD service eligibility.
• Provides benefits and entitlements technical and hands on support to the Care Management department, as needed.
• Participates in and/or facilitates meetings with all applicable members, families/representatives, and providers to complete benefits access functions.
• Provides routine updates and information to supervisor for eligibility trend reporting and follow-up actions.
• Participates in meetings with the Care Connection team and share updates on eligibility expirations, follow-up actions, documentation submission and recommendations for ensuring eligibility.
• Notifies supervisor of Medicaid recertification issues and informs of lapse in coverage that may affect enrollment in CCO and/or various other programs.
• Forms and maintains working relationships with all DD Regional Offices, Revenue Support Offices, HRA/Medicaid offices, with the goal of ensuring that the CCO is positioned as a responsive CCO for all eligibility, benefit, and enrollment needs.
• Attends department/team meetings, trainings, supervisions, etc. as scheduled and in accordance with agency practice and policy
• Completes all required training. Maintains confidentiality.
• Performs other duties, as assigned.
• Must possess a valid Drivers License from New York, or a contiguous state (i.e., Connecticut, New Jersey, Pennsylvania, and Vermont) OR must have the ability to take ample public transportation to attend meetings in person in the community and in the office as needed.

Education and Experience:

• Bachelors degree plus one-year experience completing enrollment or benefit acquisition/coordination for OPWDD supports and services.
• Demonstrated knowledge regarding access to and support to the maintenance of member benefits (Medicaid)
• Proficiency with the use of Microsoft Excel and other software products used for tracking the flow of information.
• Experience using OPWDD CHOICES system, and ePACES a plus.
• Absolute sense of integrity and personal commitment to serving people with I/DD and their families.
• Excellent interpersonal, communication organization and demonstrated ability to manage multiple tasks simultaneously.
• Ability to work autonomously.
• Demonstrate professionalism, respect, and ability to work in a team environment.