Eligibility Specialist

Eligibility Specialist

Region VII Area Agency on Aging is accepting applications for a highly motivated Eligibility Specialist. Choose a challenging and rewarding career where you can enjoy a deep sense of personal satisfaction by making a positive and meaningful difference in the lives of others. We are a growing non-profit organization based in Bay City, MI. We believe in advocating, planning, developing, and supporting a comprehensive system of quality care and services designed to achieve the optimum level of health, well-being, and independence of people as they age.

The Company: Region VII Area Agency on Aging is a non-profit organization that helps seniors, adults with disabilities and their families have greater independence in their homes and communities and is known for the great care we take with clients and employees alike. We believe in advocating, planning, developing, and supporting a comprehensive system of quality care and services designed to achieve the optimum level of health, well-being, and independence of people as they age.

Brief Summary of Purpose of Position

The Eligibility Specialist determines the eligibility of participants to participate in the MI Choice Waiver and/or other programs as needed, and ensures accuracy in performance and targeting program clientele for a multi-county service area. Serves as a liaison between agency and community-based agencies regarding issues related to service provision, direct intervention issues and/or participant advocacy.

Responsibilities and Duties

• Conducts in-take/prescreening on MI Choice Waiver or other program referrals to determine eligibility for Waiver or other assistance service programs, inclusive of wait list management.
• Develops and maintains a working knowledge of the regulations and procedures for human service, private insurance and third party reimbursement, and consults with Management on these issues.
• In cooperation with the WA/CM Manager, participates in staff orientation/training with to ensure a proper work environment, effective customer service, and that program eligibility components are understood.
• In cooperation with the WA/CM Manager, assigns Waiver Referrals to Waiver Staff teams based on applicable geographic region.
• In cooperation with the WA/CM Manager, initiates and coordinates all participant transfers from other Waiver agencies and AAA's.
• May participate in public relations activities to represent a favorable image for Region VII AAA Programs.
• Assists with the development and/or maintenance of the program manuals and records, updating as necessary to ensure accuracy and compliance.
• Participates in internal and external quality assurance reviews as necessary.
• Participates in staff development and training activities.

Qualifications and Skills

• Associate's Degree with a minimum of two years in community health programs preferred.
• Licensed Practical Nurse (LPN) preferred. Additional related experience or combination of education and experience may be considered if, in the opinion of the organization, equivalency is established.
• Ability to communicate with elderly or disabled participants on a one-to-one basis, analytic and organizational abilities, interviewing and listening skills, assertiveness skills, and ability to work effectively as a member of an interdisciplinary team.
• Must be able to read and interpret documents such as Medicare and Medicaid policies and interpret supporting documentation.
• Working knowledge of public programs including local community health and social service network required.
• He/She must be willing and able to travel within all ten counties of the region (and at times out of the region area) in reliable transportation.
• Computer experience is necessary.

Why Join Our Team?

• Medical, Dental and Vision Insurance Offered (Premiums 100% Employer Paid)
• Health Savings Accounts (Company Contributing)
• Competitive 401K Retirement Plan with Generous Company Match
• Short Term/Long Term Disability (Employer Paid)
• Paid Time Off
• Paid Company Holidays
• Life Insurance (Employer Paid)
• Exceptional Work Environment where all team members are valued

OSHA CATEGORY: This position in the regular course of business would not encounter any tasks or situations involving exposure to bodily fluids.

PHYSICAL DEMANDS: The duties of this position are consistent with those of a regular office work environment as well as those of attending to participants in a home setting. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.