Employment Opportunities

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Eligibility Specialist

 
Northland PACE – Bismarck

Full Time -   : 05/31/2019

Apply on line at www.northlandpace.com or email cover letter and resume to Amanda Erickson at aerickson@northlandhealth.com 

Job Summary: Essential functions of this position include determining eligibility for potential enrollees into the PACE program, and re-certifications of current PACE Participants, for various economic programs which may include SNAP, Medicaid, LIHEAP, Housing and Medicare.  This position may interpret County, State or Federal policies, process applications, establish and maintain electronic data, perform necessary actions relating to fraud and appeals, attend training sessions and workshops to keep current on State or County policies and procedures.

 

Primary Responsibilities:

  1. Determines and ensures Participant eligibility status remains current in all social programs available to them while enrolled in the PACE Program, specifically Medicaid and/or initial enrollment into Medicare.  This may include other programs as mentioned above.
  2. Assist Participants and/or family members to complete re-certification process prior to deadlines. and ensure County has paperwork within appropriate timeframes.
  3. Assist Intake and Enrollment staff for potential enrollees who need assistance with initial Medicaid/Medicare applications, including the collection of all necessary documentation required during the application process.   
  4. Ensure appropriate Release of Information (ROI) forms are signed and on file for communication with outside entities as part of Medicaid/Medicare enrollment process.  .
  5. Responsible for the Electronic Medical Record documentation on participant records. 
  6. Build and maintain rapport with County Social Services Eligibility Workers and Supervisors.
  7. Maintain records showing enrollment or eligibility in Medicare program per PACE regulations. 
  8. Attend meetings as necessary.
  9. Complete ongoing monthly training assignments in Relias.
  10. Assist with training of staff and or public presentations related to eligibility.
  11. Assist internal staff and/or external agencies to report or perform necessary actions relating to fraud, appeals, or financial exploitation. 

 

        

Eligibility Requirements:

Education:

Preference for completion of Eligibility Worker Certificate Program or AA/BA degree in business, accounting or social work; minimum High School graduate level will be acceptable if have experience as listed below.

 

Experience:

 

Minimum of 5 years of experience working with public assistance programs on a County or State level.  Preference for candidates with Eligibility Worker experience within ND Medicaid programs.

 

Number and type of employees supervised:

 

None

Licensure, registry or certification required:

 

None

 

Special Training:

 

High level of literacy with computer programs such as Word, Excel, and Power Point.

 

Physical Demands:

Must possess high level of verbal and written communication skills.  Must be able to tolerate sitting for extended periods of time.  Must be able to pass standard background and criminal record check.

 

Working Conditions:

Must be able to maintain professional and courteous working relationships with coworkers and outside agencies/personnel.  May be meeting with potential enrollees, Participants and/or family members in their home settings.  May be required to use personal vehicle for company business.  Will be performing duties primarily in a well-lit, climate-controlled environment.  Position is normally Monday-Friday, 8am-4:30 pm, however special circumstances may require some after-hours meeting with potential enrollees and/or family members.  Ability to occasionally flex work schedule is necessary.