MEDICAID ELIGIBILITY SPECIALIST
MEDICAID ELIGIBILITY SPECIALIST
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Salary Not Disclosed
1 Vacancy
Job Description
IF YOU ARE HIRED PROVISIONALLY IN THIS TITLE YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT.
The Home Care Services Program (HCSP) is a Medicaid funded program that provides long term care to medically fragile and vulnerable individuals who require assistance with activities of daily living through the Community Alternative Systems Agency (CASA) Managed Long Term Care (MLTC) Program the Assisted Living Program Care at Home Program and Homebound Medicaid. The Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications change actions and renewals for all Medicaid funded long term care programs. This unit is responsible for the processing of Medicaid eligibility for consumers who receive services through one of the HCSP programs.
Under the supervision of the Medicaid Eligibility Team Supervisor with some latitude for independent judgement and decision is responsible for the review of applicants assets and documentation to ascertain initial or continuing eligibility for Medicaid Home Care Services.
Home Care Service Programs Medicaid Eligibility Unit is recruiting for sixteen (16) Medicaid Eligibility Specialists who will:
Review Medicaid applications and renewals for consumers applying for or in receipt of Home Care Services. Review documentations for completeness and adequacy to make the appropriate eligibility decision using the applicable NYC NYS and Federal guidelines and procedures.
Complete the required case action utilizing the Welfare Management System (WMS) and various external program applications such as the Eligibility Data Image Transfer System (EDITS) Plus the HRA One Viewer and eMedNY and complete the requisite consumer notices forms and system updates.
Determine whether additional documentations are required or referrals to an outside agency is necessary to make an eligibility decision.
Consult with the Units Supervisor as needed on overall problems and complicated cases to ensure timely completion of work within strictly enforced timeframes.
Work Location: 470 Vanderbilt Avenue Brooklyn NY 11238
Salary Range: $42485 $$48858
Qualifications :
1. Completion of 30 semester credits at an accredited college or university; or
2. A four high school diploma or its educational equivalent and one year of fulltime satisfactory experience in one or more of the following areas; performing the work described below:
a. Interviewing gathering information and/or preparing necessary documentation for the purpose of making recommendations concerning eligibility for public assistance or unemployment health benefits social security insurance or participation in social services or community programs and other similar benefits; or
b. Performing bookkeeping bank teller duties housing office teller duties purchasing agent assistant store manager sales representative responsible for accounts or customer service duties or a job in which the duties include helping customers with questions or concerns; or
c. Dealing with social service agencies legal representatives or aiding individuals in navigating housing social financial or health problems or application systems; or
3. A satisfactory combination of education and/or experience equivalent to 1 or 2 above. College education may be substituted for the experience in 2 above on the basis that 30 semester credits from an accredited college or university may be substituted for each year of required experience. However all candidates must have at least a four year high school diploma or its educational equivalent.
Special Note
Work experience which provides only incidental opportunities to perform the job duties as described in 2a 2b and 2c above are not acceptable for meeting the minimum qualification requirements.
Additional Information :
The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic including but not limited to an individuals sex race color ethnicity national origin age religion disability sexual orientation veteran status gender identity or pregnancy.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
