Erap Eligibility Specialist Jobs

2 years previous experience working at or with an HMO or MCO organization required

A bachelor's degree may substitute for the years of required work experience

Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption

High school diploma or GED required

Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports

Research and resolve member eligibility issues thoroughly, timely, and accurately

Perform managed care enrollment activities on the Welfare Management System (WMS).

Evaluate State of Health managed care issues and make next step determinations.

Review enrollment issues using WMS, eMedNY and other State Medicaid Data systems.

Interact with local district, SDOH, eMedNY and Enrollment Broker staff to resolve MC issues.

Meets all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.

Upload scanned images into the document management system.

1+ year of Call Center Experience

Provide 2-3 professional references if requested (managers/supervisors/leadership)

Receive and screen applications, and follow-up with customers to gather any missing information.

Verify income, calculate income, determine eligibility, and process case referrals.

Index and scan returned forms.

Determines priority of eligible applicants for housing selection and coordinates applicant placement with housing managers.

Prepares and mails application for continued occupancy to residents with reasonable written notice of actions needed to complete their recertification timely;

Prepares recommendations for improvement or correction of deficient recertification activities;

Review, approve and reject applications for housing based on federal and agency regulations;

Counsels' prospective tenants on the policies and procedures relative to obtaining and maintaining a unit.

Determines residents who qualify for Earned Income Disregard (EID) exclusions;

Desirable Knowledge, Skills, and Abilities

Sherburne County offers a comprehensive benefits package, including:

Knowledge of Federal and State structure, rules and policies governing Income Maintenance Programs.

Performs job responsibilities in a manner consistent with the County's vision, mission, and values.

Informs immediate supervisor of all-important matters pertaining to assigned job responsibilities.

The primary responsibilities for this position will be performed approximately 100% of the time indoors.

Respond to emergency needs of clients along in collaboration with program social worker and case manager;

Experience working with special needs populations;

Strong oral and written communication skills;

Knowledge of housing law or capacity to learn;

Complete applications and eligibility determinations for consumers and/or households applying to HCS for financial and/or housing assistance;

Apply federal, state, and local regulation towards determining eligibility for housing and support services programs;

Computer Skills (CLIK) – A basic computer literacy test, assessing knowledge of internet browsers, email, chat, and word processing.

Basic Competency (CBST) – A test of basic math, verbal, and communication skills, designed to assess job readiness and trainability.

If you experience problems applying online, please call the People First Service Center at (877) 562-7287.

Benefits of Working for the State of Florida:

For a more complete list of benefits, visit www.mybenefits.myflorida.com.

Interviewing applicants to obtain and verify information needed to determine eligibility for Food Assistance, Medicaid, and Cash Assistance.

Qualifications - Education and Experience

Meet the needs of consumers, follow through, meeting deadlines, and maintain skills and knowledge to perform the job.

Apply the required knowledge and skills and exhibit critical thinking and problem solving.

Exhibit good work habits, including organizational skills, regular attendance, working independently, seeking and offering assistance when needed.

Work or volunteer experience working directly with consumers in social service type settings. Experience can be substituted for education.

Any combination of related education and relevant work experience equaling at least 4 years.

Knowledge, Skills & Abilities (KSAs):

Use logic, problem solving techniques, and analytical skills

Must have a high school diploma or General Equivalency Diploma (G.E.D) and 3 years of customer service experience.

A top-ranked retirement program with lifetime pension benefits

Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)

Defined benefit plan that provides for life-long income upon retirement.

Initiate contact with ongoing long term care recipients as required to complete their annual financial recertification.

Redetermine ongoing financial eligibility for benefits by reviewing application packets and other supplemental data as required by current policy.

Experience working in a team environment.

THIS IS WHAT YOU NEED TO QUALIFY/MINIMUM QUALIFICATIONS (MQ's):

Provide choice counseling and facilitate referrals to SHIBA, Medicare and community programs as appropriate.

Write case notes in all circumstances as required by program or policy rules.

TO APPLY PLEASE VISIT THE LINK BELOW

Applicants who do not apply using the dhsjobs link provided will NOT be considered.

For other DHS career opportunities, please visit: http://dhsjobs.dhs.ga.gov

Knowledge of Welfare Management System (WMS), Paperless Office System (POS), HRA One Viewer, and Electronic Medicaid of New York (eMedNY).

Perform quality assurance for Enterprise Data Warehouse (EDW) queries, and Welfare Management System (WMS) lookups.

Review Duplicate Client Identification Number (CIN) cases to determine which CIN should be disenrolled.

Process invalid Social Security Numbers files produced by Family Independence Administration (FIA) to assist in reducing fraud.

9:00 am to 5:00 pm

Conduct client interviews and collect detailed information on their business and experience

Research governmental mandates and information to supplement ERC eligibility on a case-by-case basis

Research specific orders that caused disruption to client’s business operations

Analyze and interpret data gathered to guide decision making

Create reports to summarize research findings and the implications of the results

Perform compliance reviews to ensure accuracy and completeness

Ability to multi-task using multiple computer systems with strong organizational and time management skills

Performs other responsibilities as assigned

One year of enrollment data or other related work experience

Beginner Excel experience required, Intermediate preferred

Demonstrated attention to detail and analytical skills relating to reconciling and problem-solving using data

Previous experience working with health insurance or in a health care environment preferred

Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.

15 days annual (vacation) leave per year.

15 days sick leave per year.

State Retirement Plan and Deferred Compensation Programs.

Overtime and/or weekend work with Deputy approval.

Sitting or standing for long periods of time.

Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.

15 days annual (vacation) leave per year.

15 days sick leave per year.

State Retirement Plan and Deferred Compensation Programs.

Overtime and/or weekend work with Deputy approval.

Sitting or standing for long periods of time.

Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.

15 days annual (vacation) leave per year.

15 days sick leave per year.

State Retirement Plan and Deferred Compensation Programs.

Overtime and/or weekend work with Deputy approval.

Sitting or standing for long periods of time.

Have good organizational, multi-tasking, and time management skills, with excellent attention to detail.

Have advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables, etc.

Have knowledge of EDI 270/271 transactions and insurance eligibility verification Have strong work ethic, resourcefulness, and the motivation to succeed

Have experience working with insurance companies in the healthcare provider industry

3-5 years previous experience in medical billing, current A/R & experience in patient services a plus.

Maintain knowledge of industry standards for insurance verification Understand and adhere to HIPAA policies, procedures, and regulations, maintaining strict confidentiality

2 years previous experience working at or with an HMO or MCO organization required

A bachelor’s degree may substitute for the years of required work experience

Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption

High school diploma or GED required

Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports

Research and resolve member eligibility issues thoroughly, timely, and accurately