Entitlement and Eligibility Coordinator - New York, NY

Position Description:
Working in Operations at UnitedHealth Group is one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.If it sounds too good to be true, consider this: 

Through our family of businesses and a lot of inspired individuals, we're building a high-performance structure that works better for more people in more ways.
Primary Responsibilities:

Provides
assistance to current and prospective members, as well as the interdisciplinary
care team, in relation to concrete entitlement/benefits and eligibility issues. Also assist in various administrative functions of the Managed Long Term Care
Enrollment (MLTC) department and MCO complex care division, under guidance of
the Entitlement/Eligibility Supervisor.
Provide direct support to Enrollment/Eligibility dept. management and others
of the MLTC department and the interdisciplinary care team with respect to Medicaid
and Medicare eligibility.Assist the Enrollment/Marketing team to evaluate prospective for Medicaid
eligibility as needed, and assist these individuals and their caregivers with
the Medicaid application process.Prepare Medicaid recertification packages for current enrollees and
coordinate processing of same with Local District Social Services.Interact closely with representatives of Maximus, enrollment broker and/or NYC
HRA concerning problematic Medicaid issues to facilitate their successful
resolution, fair hearings and local conferences.Perform administrative functions as designated by Enrollment management,
including tracking of member Medicaid eligibility and recertification and
coordination of paper documentation in member records and billing records.
Participate in periodic training on-site and in community to facilitate
understanding of critical issues relating to entitlements/benefits and long
term care practice.Complete all other government entitlement applications as directedAssist with eligibility issues of complex care population in MCO, including
Nursing Home residents
Abides by all applicable local, state and federal rules and regulations and
agrees to abide by the Code of Conduct and Compliance Program.Other duties as assigned.Assist in file reconciliation activitiesAssist with
tracking and management of spenddown, NAMI and trust activities as
assigned  

Requirements:

High School Diploma or GED 2+ years Medicaid eligibility/enrollment
experience in a managed care setting Strong knowledge of NYS
Medicaid/Medicare and regulations requiredBasic level of proficiency with
Microsoft Office(Word, Excel, Outlook)

Assets:

 

3+ years of experience with entitlement/benefit
support in a NY Managed Long Term Care Plan. Comparable experience in other NY
Long Term Care programs or social service agencies, preferably with
geriatric client population, will be considered. Associates or Bachelor's DegreeKnowledge of clinical support or claims
systems desired.  Experience with Data
entry or Data management in Excel highly desired

Soft Skills:


Able to communicate in person and over the telephone
Able to grasp importation information when communicated
Undertakes and initiates self-directed activities and asks for assistance as
needed
Utilizes exemplary customer service principles in all areas of job
responsibilities.
Appreciation of cultural diversityExcellent
oral, written, and interpersonal skills

Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.