• Entitlement Coordinator

    Job Locations US-NY-Brooklyn
    Req #
    107124
    Agency
    Elderplan
    Status
    Regular Full-Time
    Location : Postal Code
    11220
    Category
    Office and Administrative Support
    Office or Field
    Office-based
  • Overview

    The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

    Responsibilities

    The Entitlement Coordinator maintains up-to-date knowledge of HomeFirst Managed Long Term Care Plan (MLTCP) and the entitlement process. Entitlement Coordinator is responsible for conducting mail and telephonic outreach to verify and assist in the Medicaid enrollment eligibility of a Prospect. This individual coordinates Nursing Home discharges with HRA/LDSS, the Nursing Home, HomeFirst Clinical Enrollment and UM departments, and the prospect/caregiver. Entitlement Coordinator reviews, analyzes, and reconciles all enrollment files from Maximus, including rejections, and compares them to Homefirst Upload files.

     

    This individual proactively troubleshoots and coordinates with HRA/LDSS to ensure the accuracy of outgoing and incoming eligibility information and provides solutions to issues as they arise. Entitlement Coordinator has extensive knowledge of HRA/LDSS and NY state systems, such as eMedNY / ePaces and knows how to utilize these systems to confirm enrollment eligibility. This individual is responsible for assisting in the oversight and maintenance of all logs & reports associated with Entitlement, which delineate productivity, timeframes, and quality of HomeFirst Enrollment’s Entitlement processes and outcomes. Entitlement Coordinator adheres to all HIPPA standards and confidentiality requirements and is responsible for problem solving as new duties arise and volumes fluctuate.

    Qualifications

    • High School Diploma or equivalent, required; Associate’s Degree, preferred
    • Minimum of (2) years’ experience in a health related field or commensurate experience in Managed Care with a concentration in Medicaid/Medicare eligibility, preferably with the geriatric population
    • Familiarity with Medicaid/Medicare concepts, procedures, and enrollment practices, preferred

    Benefits

    We truly value our staff and further acknowledge their contributions by offering:

    • Employee and family health coverage
    • Competitive salaries
    • Employer contributed pension plan
    • Generous time off
    • Tuition reimbursement
    • 403(b) retirement plan

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