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Eligibility Specialist

YAI is seeking an experienced Entitlement Specialist to join the Fiscal group. The successful candidate will be responsible for Medicaid eligibility for the people we support.

Responsibilities will include:
  • Work with program staff on Food Stamp applications and re-certifications to ensure that we are maximizing the food stamps of the people we support
  • Capture food stamp revenue on a monthly basis centrally
  • Work with the Department of Finance/DARB Unit to ensure the Medicaid spenddowns are being processed
  • Responsible for completing and processing Medicaid applications and re-certifications for the people we support in the residential programs for YAI.
  • Work with Program staff in:
  • processing Medicaid applications
  • answering eligibility questions
  • providing support with family situations
  • obtaining spenddown amounts and status of payments
  • adjusting spenddown amounts by submitting necessary paperwork to Medicaid's spenddown unit
  • Responsible for reviewing Medicaid rejections and taking corrective action. This includes:
  • obtaining NOD's from programs and submitting to OPWDD and Medicaid
  • contacting CCOs to alert them of a lapse in coverage for people we support in various programs (i.e Community Habilitiation, Respite, Day Services)
  • advising programs of spenddown not being processed
  • collecting documentation to submit to various government agencies

Requirements:
  • BA or BS
  • 1 - 2 years ID/DD or related social service experience preferred
  • 1 – 2 years of Medicaid and Medicare entitlement experience preferred
  • Ability to work as part of a team and independently
  • Excellent written and verbal communication skills

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or status as a Vietnam or disabled veteran. YAI is an Equal Opportunity Employer.