Eligibility Specialist

Job Description

Job Description

Care with Heart. Work with Purpose.
Join The Senior Community Care of Kentucky PACE as a Eligibility Specialist in Louisville, KY. This is more than a job! It’s a paid opportunity to serve others, live our mission, and make a meaningful impact in a healthcare setting. If you’re ready to grow your career while making a difference, we’d love to connect with you.

Senior Community Care of Kentucky PACE is a community of Volunteers of America National Services, a subsidiary of the Volunteers of America parent organization. Proudly Great Place to Work® Certified for 8 consecutive years.

Pay Range: $47,000 - $54,000, based on experience
Schedule: M - F, 8:00am - 5:00pm, occasional weekends and evenings

*This position will oversee both sites, and will also do home visits in Jefferson County*

Why You’ll Love It Here

• Supportive, caring leadership that truly values your voice
• A positive, team-oriented environment where you can rely on one another
• A beautiful, welcoming campus you’ll enjoy coming to each day
• Opportunities for career growth and ongoing development
• Purpose-driven work that makes a meaningful difference every day

 

What We Offer

• Medical, Dental & Vision Insurance
• 403(b) with discretionary contribution
• Paid Time Off + Personal Days
• Life Insurance & Short-Term Disability
• Employee Assistance Program
• Wellness incentives (earn up to $350)
• Get paid early (access up to 50% of earnings)

 

OBJECTIVE : Under the supervision of the Marketing Manager/Enrollment Supervisor obtains initial information relating to admissions, coordinates intake process, and provides information and referrals to community agencies as appropriate. Supports enrollment team with eligibility. Promotes the Senior CommUnity Care Program to potential participants and community agencies.

QUALIFICATIONS:

• Must have medical clearance for communicable diseases and up-to-date immunizations after having direct participant contact.
• Must have a valid driver’s license and have means of transportation.
• Must clear background check.
• Education: Bachelor's Degree in a health and human services field or equivalent four (4) years of experience related to public benefits.
• Experience: Two (2) years of experience in case work for public assistance programs or in an information and referral resource role within senior services.
• Must be familiar with benefits available to older adults. Shall have either training or related experience in the job assigned.

Essential Functions:

• In collaboration with Enrollment Specialist, gather necessary documentation and application requirements in working with participants for Medicaid approval.
• Ensures compliance with all State Medicaid Rules and Regulations that pertain to Long Term Care Medicaid.
• Assists participants with applications to Supplemental Nutrition Assistance Program (SNAP), and other state specific Medicaid or public assistance programs for which participants may be eligible.
• Tracking private pay and Medicare-only clients and instrumental in obtaining a smooth transition to Medicaid eligibility. Ensures appropriate forms are completed and participant understanding of
  financial responsibility when not eligible for Medicare or Medicaid.
• Works with Health Plan Operations Team and Executive Director to ensure A/R Aging report is tracked and monitored, and outstanding debts are collected.
• Reviews and monitors eligibility report provided by Health Plan Operations Team to ensure participants who lose benefits are provided support with re-establishing eligibility.
• Guides participants through financial eligibility process. Supports participants with gathering and submitting supplemental documents which are required to establish eligibility for benefits.
• Provide education on program regulations and other pertinent material to applicants, recipients, and the general public.
• This role is a provider authorized representative for participants’ Medicaid benefits. Reviews Medicaid eligibility, monitors time frame for re-certification and facilitates Medicaid applications for certification
  and re-certification using state specific Medicaid process.
  Collects data and prepares reports in accordance with Centers for Medicare and Medicaid Services (CMS) requirements or program requirements.

 

About Us  

Senior Community Care of Kentucky PACE (Louisville) provides healthcare and supportive services for individuals age 55 and older, helping them live safely, comfortably, and independently in their own homes and communities. As a Program of All-Inclusive Care for the Elderly (PACE) provider, our interdisciplinary teams deliver personalized, comprehensive care tailored to each participant’s needs.  Located in the heart of Louisville, a vibrant riverfront city known for its friendly communities and rich culture. Convenient access to well-known landmarks such as Churchill Downs and the Kentucky Derby, offering walking paths, parks, and peaceful views. 

 

At VOANS, we celebrate sharing, encouraging and embracing diversity. Equal employment opportunities are available to all without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, parental status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law. We believe that blending individual strengths and unique personal differences nurtures and supports our organizations’ shared commitment to our mission and creates an inclusive and diverse environment where everyone feels valued and has the opportunity to do their personal best.