Position Overview
Reporting directly to the Unit Supervisor, Aging & Disability Resource Center, and working under general supervision, the incumbent is responsible for facilitating access to and determining Medicaid eligibility for those seeking assistance. Essential to this position is the ability to understand and communicate over the phone and in person the various components of Medicaid programs to the served population. The primary responsibilities of the Medicaid Benefits Counselor involve eligibility determination; however, all activities may be performed to meet the needs of the department.
Primary Accountabilities
Accept referrals from the Elder Helpline as well as other resources for intake and screening. Determine the individual's needs and screen for potential eligibility for Medicaid-related services utilizing a standardized screening instrument. Provide efficient, timely and consumer friendly services to facilitate the eligibility application and review process. Verify an individual's current Medicaid eligibility status for purposes of the Medicaid eligibility process. Explain Medicaid eligibility rules and the Medicaid eligibility process to prospective applicants. Conduct comprehensive screening on Medicaid probable individuals on the Assessed Priority Consumer List (APCL) who are not active in a case managed program. Input client assessments into CIRTS (Client Information and Registration Tracking System) Post information in the enrollment and termination screens of CIRTS to update the APCL as needed. Provide necessary forms and package all forms in preparation for Medicaid eligibility determination. Gather information related to the application and eligibility determination for an individual, including resource information and third-party liability information, as a prelude to submitting a formal Medicaid application. Assist individuals with acquiring forms and compiling required documentation, provide technical assistance, coordinate with eligibility determination professionals, and perform all other duties related to completing and submitting a Medicaid application. Assist the individual in collecting and gathering required information and documents for the Medicaid application. This assistance may be provided in the individual's home. The activity includes assisting the potential applicant, as a secondary resource to family members and care providers, in gathering information and completing an application for Medicaid benefits. Refer the individual to the local (or ADRC collocated) Department of Children and Families/ Automated Community Connection to Economic Self-Sufficiency (DCF/ACCESS) staff to make application for Medicaid benefits. Coordinate with these staff regarding eligibility matters for Medicaid eligible or potentially eligible individuals.
Assist in obtaining the Physician Referral form (3008) for Medicaid Waiver probable individuals and coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of functional eligibility. Collect, review and maintain accurate Medicaid eligibility determination tracking data to ensure completeness,accuracy and timeliness. Track Medicaid applications through the eligibility process. Input enrollment management system (EMS) tracking information into the CIRTS MedicaidWaiver Timeline. Contact individuals on the APCL as required to update information and screen for Medicaid eligibility. Participate in meetings with DCF, CARES and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process. Act as a consumer advocate by coordinating with CARES and DCF/ACCESS staff to resolve in a timely manner any eligibility issues that arise during the Medicaid eligibility determination on process. Standardize and make consistent outreach efforts to ensure public awareness of Medicaid programs and services and how to access them. Develop, compile and distribute materials to inform individuals about the Medicaid programs as well as how and where to obtain those benefits. Note:This activity does not include compiling information already available through the Medicaid agency or Departmentof Elder Affairs. Build relationships with and educate service providers, professional entities and other professionals, such as hospital discharge planners and nursing home social workers, to facilitate referrals and increase awareness of Medicaid resources. Regularly meet with and train ADRC access points to increase awareness of Medicaid resources to individuals and target populations. Knowledge of computer applications to perform the functions of the position, including wordprocessing, database, and spreadsheet applications. Perform other Medicaid-related duties as assigned, which may include counseling disaster victims about Medicaid programs, options and the eligibility process. Assists with the Alliance For Aging’s response following a disaster or emergency, as needed. Specific tasks will be assigned by the supervisor, based on need and the incumbent’s availability
Education, Skill Requirements and Essential Functions
The ideal candidate will possess: Bachelor's degree in social work, psychology, gerontology, or related social services field, plus one {1) year of related work experience, or a Bachelor's degree in another field of study not related to social services, and two (2) years of related work experience. (Professional human service experience as a caseworker, case manager, intake specialist, or related work experience with the long-term care population may substitute for a Bachelor's degree on a year-for-year basis). Strong communication skills, attention to detail and organizational skills. Ability to utilize crisis intervention style techniques to de-esca late verbal confrontations with difficult individuals. Ability to relate to older persons and be able to deal with the general public effectively over the telephone and in person in a receptive manner. Ability to handle telephone equipment while utilizing electronic software designed to access information. Ability to work independently as well as in a team environment. Knowledge of computer applications to perform the functions of the position. Demonstrated PC ability to include Microsoft Office products, especially Word and Excel, and database applications. Knowledge of and ability to navigate CIRTS, FMMIS, and DCF Florida System. Experience in training, including public speech and developing training materials and the provision of training and ongoing technical assistance. Ability to type a minimum of 45 words per minute on PC and possess strong English grammatical and spelling skills. Ability to work independently with minimal supervision. Bilingual(English/Spanish) preferred.
Job Type: Full-time
Pay: $43,878.13 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Education:
Experience:
- Case management: 2 years (Required)
Ability to Commute:
- Miami, FL 33172 (Required)
Work Location: Hybrid remote in Miami, FL 33172
