Entitlement Specialist

TITLE: Entitlement Specialist

REPORTS TO: Director of Entitlements

LOCATION: Manor - 219 East 121st St. New York, NY 10035

Our Mission:

Since 1967, Odyssey House has gone beyond helping individuals beat drugs and alcohol. We help rebuild lives. There’s more to recovery than just getting clean. We help individuals get healthy again, too, with medical and dental care, fitness programs, support for your mental health and more. Individuals can stay with their children while in treatment, while learning new life skills, so they can stay together and repair other broken relationships in their lives. We provide educational and work skill trainings, outpatient services and available housing assistance, so individuals can step back into real life with a real future.

If that sounds different than other treatment programs, you’re right. Because Odyssey is where recovery gets real.

MAJOR FUNCTIONS:

Maintain a working relationship with the Department of Social Service (DSS), Human Resources Administration (HRA), Social Security Administration (SSA), Medicaid Office, NYS Office of Temporary and Disability Assistance to obtain appropriate funding. To ensure that all funding guidelines, policies, and procedures are follow.

SPECIFIC DUTIES & RESPONSIBILITIES:

• Conduct daily comprehensive review of consumers’ interviews to determine eligible for Entitlements benefits, Medicaid Eligibility, Medicare, and Managed Care coverage

• Interviews new admission for HRA/DSS/SSI/SSD/Self-Pay/30% scale

• Contact Department of Social Services (DSS), Human Resources Administration (HRA) to schedule initial appointments for the process of clients’ benefits (Room & Board, PNA, SNAP) and Medicaid coverage

• Assist consumers with the completion and submission of Public Assistance recertification, reapplying process, Fair Hearings, Fraud Investigations, SSI/SSD Redeterminations, State change of payee, SNAP recertification, Medicaid renewal and SSDI continuing disability reviews

• Assist consumers obtaining documentations such as Birth Certificates, Social Security card, unemployment/employment verification, documents required for DSS/HRA application processes

• Educate consumers on benefits-related issues and/or other issues that may arise

• Escort consumers to various government and city agencies

• Navigate Epaces (eMedNY) / Inovalon / STARS / SAAMS / AWARDS / WTW / Manage Care System Portals for coverage

• Report changes on STARS (Transfers/LACA/Discharges/Program Complete)

• Update SAAMS / Westchester weekly attendance / monthly Progress Reports (Orange, Rockland, Nassau, Suffolk Counties)

• Maintain up-to-date files with approvals, budget, and award letters from the Human Resources Administration (HRA), Social Security Administration (SSA), State Department of Social Services (DSS), Self-Pay and 30% agreements calculations

• Daily communication with facilities to verify residents’ HRA two-part phone calls appointments interviews, Social Security change of payee process, and follow up on missed appointments

• Entitlement Reports:

          o Monthly Database update with consumers’ benefits

          o AWARDS update with Medicaid/Medicare/Private Insurance

          o Westchester monthly Progress Reports

• Maintain a filing system in place for Entitlement active and inactive charts for 7 years.

• Other relevant duties as assigned

REQUIREMENTS: EDUCATION/TRAINING AND EXPERIENCE KNOWLEDGE, SKILLS AND ABILITIES

• BA Degree preferred in Human Services or related field

• Knowledgeable with HRA/DSS, SSA, Self-Pay, 30% working client scale

• Background with DSS/HRA recertifications, Medicare, Medicaid managed care

• Demonstrated effective communication, proficiency in Excel, computer skills, organization and multitasking

• Notary Public Stamp

Odyssey House is an equal opportunity employer maintaining a non-discriminatory policy on hiring of its personnel. Odyssey House, and its operational divisions, will not discriminate against any employee or applicant because of race, creed, color, national origin, sex, disability, marital status, sexual orientation or citizen status in all employment decisions including but not limited to recruitment, hiring, upgrading, demotion, downgrading, transfer, training, rate of pay or other forms of compensation, layoff, termination and all other terms and conditions of employment.