What are the responsibilities and job description for the Eligibility Assistance Specialist position at Mount Rogers Community Services Board?
Job Description
OPEN UNTIL FILLED
JOB SUMMARY:
The eligibility specialist assists individuals served with filing for Medicaid, Social Security Disability benefits, SSI, and Medicare Part D Prescription Plans. Provide assistance to individuals served in completing applications for financial assistance with our local hospitals, food stamps, etc. As a SOAR (SSI/SSDI Outreach, Access and Recovery) representative, the goal is to help those that are disabled and homeless through an expedited process for their disability claim.
ESSENTIAL FUNCTIONS:
- Assist individuals enrolled in services with filing for Medicaid, Social Security Disability benefits, SSI, and Medicare Part D Prescription Plans. Once notified by referral, schedule appointment with the individual to complete screening and determine the potential for benefits. Proceed based on screening results.
- As a SOAR (SSI/SSDI Outreach, Access and Recovery) agency representative, the goal is to help those that are disabled and homeless through an expedited process for their disability claim. Assist these individuals in the application process. Complete the critical Medical Summary Report to ensure the individual’s history of homelessness, legal involvement, and medical/mental health diagnoses support the disability. Coordinate with the agency eligibility lead (Credentialing and Reimbursement Compliance Specialist) to resolve problems with DDS/SSA. Complete required data entry (OAT system).
- Work closely with Disability Determination Services to gather medical evidence in support of individual’s disability claims. Assist in filing appeals on behalf of individuals who have been denied disability benefits.
- Provide individuals a listing of required documentation necessary to file claims. Monitor and track progress with individuals to ensure timelines are met.
- Develop and maintain a close relationships with all six local Departments of Social Services in our service area to ensure that individuals apply for every benefit to which they are entitled.
- Provide assistance in completing applications for financial assistance with local hospitals, food stamps, internal prescription funds, etc. Provide individuals with other community resources and contact information as necessary.
- Assist individuals in the Spend Down process. Work with Department of Social Services to determine spend down amounts and timeframes for these individuals. Update electronic health records regarding spend down.
- Monitor uninsured individuals based on data in the electronic health record. Contact individuals and notify program staff regarding the changes in benefits. Assess the need and provide assistance to reinstate benefits if possible.
OTHER DUTIES:
- Obtain and maintain SOAR certification.
- Provide education and training to other agency support staff regarding individuals’ eligibility and benefits.
- Perform other job-related tasks as assigned by supervisor.
QUALIFICATIONS:
- Read and comprehend comprehensive medical records
- Write clear and concise detailed reports
- Understand and comply with policies and procedures
- Strong personal skills
- Work independently and perform multiple tasks
- Must be able to develop and maintain professional, service-oriented working relationships with individuals, providers, co-workers, supervisors, and outside agency representatives
- Knowledge and skill of agency electronic health record
- Knowledge and ability to navigate and perform work duties within multiple databases and portals
Job Requirements
EXPERIENCE/EDUCATION REQUIRED:
- Associates degree preferred or equivalent eligibility benefit experience or a combination of education and experience to total four years.
- SOAR certification to be obtained within 12 months of hire.
