Benefits Eligibility Specialist bei None

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Under the supervision of the HCBS Administrator, the Benefits Eligibility Specialist plays a critical role in ensuring that people maintain their eligibility for and access to benefits which support their health, independence, and quality of life. These benefits include Medicaid/Medicaid Waivers, Social Security, asset protection savings accounts and trusts, and supplemental housing and food benefits. The Benefits Eligibility Specialist is expected to demonstrate a high level of attention to detail and strong organizational skills, and to work collaboratively across teams.

JOB-SPECIFIC DUTIES AND RESPONSIBILITIES 

Inclusion & Engagement for People Supported

· Facilitate and model inclusive interactions and relationships.

· Ensure access to benefits which allow people to live successfully in their communities.

· Escalate issues which negatively impact the quality of life and choice for people supported.

Medicaid/Medicaid Waiver Eligibility 

· Execute identified process to prepare and submit Medicaid/Medicaid Waiver applications and redeterminations by established due dates, ensuring continuous eligibility for people supported.

· Monitor mail and databases for Medicaid/Medicaid Waiver eligibility communications, alerting appropriate team members to outstanding issues and securing and submitting additional documentation when required.

· Track status of Medicaid/Medicaid Waiver applications and redeterminations.

· Collaborate with internal and external team members to resolve Medicaid/Medicaid Waiver closures and denials.

· Support Medicaid/Medicaid Waiver audits, records reviews, and appeals.

· Research and report eligibility status for new program applicants.

Social Security Eligibility 

· Execute identified process to prepare and submit Social Security applications and redeterminations by established due dates, ensuring continuous eligibility for people supported.

· Execute identified process to prepare and submit Representative Payee applications and required reporting by established due dates.

· Monitor mail and databases for Social Security eligibility communications, alerting appropriate team members to outstanding issues and securing and submitting additional documentation when required.

· Track status of Social Security and Representative Payee applications and redeterminations.

· Support Social Security and Representative Payee audits, records reviews, and appeals.

ABLE and Medicaid Qualifying Trust (MQT) Eligibility 

· Collaborate with internal and external team members to ensure establishment of ABLE accounts and MQT to support people in maintaining their Medicaid eligibility.

· Execute identified process to prepare and submit ABLE and Medicaid Qualifying Trust applications for the benefit of people supported.

· Track status of ABLE/MQT applications and accounts.

· Monitor spend-down needs regularly to ensure people do not exceed established income/asset limits, alerting team to take any necessary actions.

Supplemental Housing and Food Benefits Eligibility 

· Execute identified process to prepare and submit federal, state, and local supplemental housing and food applications and renewals for the benefit of people supported.

· Monitor mail and databases for supplemental housing and food eligibility communications, alerting appropriate team members to outstanding issues and securing and submitting additional documentation when required.

· Track status of supplemental housing and food applications and renewals.

· Monitor spend-down needs to ensure people do not exceed established income/asset limits, alerting team to take any necessary actions.

· Support supplemental housing and food benefits audits, records reviews, and appeals.

Documentation and Recordkeeping 

· Ensure identifying documents (including current ID, Medicaid, Medicare, Social Security, other insurance, etc.) for every person supported are current, correctly filed, and accessible to the team when required.

· Ensure written records which meet identified standards and include accurate data that supports benefit eligibility are regularly received and maintained as required to support applications, renewals, and redeterminations.

· Maintain comprehensive documentation and reports which detail benefit eligibility for all people supported, including record of actions taken, contacts made, status, decisions/outcomes, etc.

· Perform regular reviews to ensure compliance with organizational policies and procedures.

Other incidental and occasional duties which are reasonably within the scope of this position may be assigned or required by the supervisor, particularly during urgent situations. 

QUALIFICATIONS 

· Master’s degree plus two years of relevant professional experience, or bachelor’s degree plus four years of relevant professional experience, or high school diploma plus eight years of relevant professional experience. 30 credit hours may be substituted for one year of experience.

· Demonstrated excellent attention to detail and strong organizational skills.

· Experience working with government entitlement benefits or with information databases. · Proficiency across the MS Office product suite and experience working collaboratively across cloud-based networks.

· Commitment to a high standard of ethics and protecting confidential information.

· Effective verbal and written communication skills and computer skills.

· Ability to read and write fluently in English and have a good understanding of the English language.