Medicaid Eligibility Specialist Jobs

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.
The Home Care Services Program Medicaid Eligibility Unit is recruiting for (20) Twenty 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 Unit’s Supervisor, as needed, on overall problems and complicated cases to ensure timely completion of work within strictly enforced timeframes.

1. Completion of 60 semester credits at an accredited college; or
2. A four-year high school diploma or its educational equivalent and two years of full-time 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 decisions concerning eligibility for public assistance or unemployment, health benefits, social security, casualty, property or liability insurance, or 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 representative responsible for making determinations; or
c. Dealing with social service agencies or aiding individuals in solving housing, social, financial or health problems as a community organization representative; 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 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. Examples of unacceptable work experience include, but are not limited to, experience as a token clerk, check-out clerk, sales clerk, teacher's aide, cashier, receptionist or secretary.

**LOAN FORGIVENESS
The federal government provides student loan forgiveness through its Public Service Loan Forgiveness Program (PSLF) to all qualifying public service employees. Working with the DSS/HRA/DHS qualifies you as a public service employee and you may be able to take advantage of this program while working full-time and meeting the program’s other requirements.
Please visit the Public Service Loan Forgiveness Program site to view the eligibility requirements:
https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service
In addition, the Human Resources Administration/Department of Social Services offers competitive salaries and the following benefits:
Generous Pension Plans (The New York Employees' Retirement System).
401(k) and Roth 457 Retirement Savings Programs.
U.S. Savings Bonds Flexible Spending Program.
Health Benefits, Dental, Vision Coverage, Prescription Drug Program.
Training and Development.
Opportunity for Scholarship; College Savings Program.
Paid Holidays and Generous Annual Leave.

IF YOU ARE HIRED PROVISIONALLY IN THE ELIGIBILTY SPECIALIST TITLE, YOU MUST TAKE AND PASS THE CIVIL SERVICE EXAM WHEN IT BECOMES AVAILABLE TO BE ELIGIBLE FOR CONTINUED EMPLOYMENT.
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This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program.

9 am – 5 pm (FLEX)

470 Vanderbilt Ave, Brooklyn, NY, 11238

New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview.