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Eligibility Benefits Coordinator

2 months ago

Lanham, Maryland, United States Ardmore Full time

The Eligibility Benefits Coordinator plays a crucial role in facilitating communication between the Finance department, LTSS Coordinator, and Services departments. This position is responsible for ensuring that individuals for whom we serve as Representative Payee maintain their eligibility for Social Security, Medicaid, and waiver programs. This is achieved by establishing a comprehensive tracking system that guarantees timely completion of annual reviews and provides auditing oversight of service documentation to ensure compliance with DDA and waiver standards.

At Ardmore, we are dedicated to fostering an environment where all employees are aligned with our mission to deliver quality support services. We believe in respecting individuals with intellectual and developmental disabilities, offering them opportunities to engage in and access community events, activities, and resources.

KEY RESPONSIBILITIES:

  • Develop and manage a database and tracking system to oversee Medicaid waiver recertification, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI) benefits, Medicare, resources, and assets.
  • Monitor Resident Fund Management System (RFMS) accounts to ensure adherence to Medicaid, SSI, and waiver guidelines.
  • Conduct SSA reviews, including annual Representative Payee reports, wage reporting, calculation of Impairment Related Work Expenses (IRWE), and annual disability reports.
  • Facilitate the transition from SSI to SSDI when a parent or individual retires and assist with Medicare insurance applications.
  • Maintain Medicaid eligibility and redetermination for all individuals served within the Representative Payee program, acting as a liaison with the Division of Waivers Eligibility Services (DEWS).
  • Assist in selecting Medicare D prescription programs in collaboration with the Nurse Manager and Delegating Nurse.
  • Track DDA waiver eligibility status for all individuals supported across services, providing assistance with waiver redeterminations as necessary.
  • Monitor spend-down requirements and support programs as needed.
  • Guide individuals in establishing Centers for Medicare and Medicaid Services (CMS) and Social Security Administration (SSA) approved benefits-protected savings accounts, including Maryland ABLE and Special Needs trusts.
  • Assist individuals in setting up irrevocable pre-needs funeral trusts and creating person-centered funeral plans aligned with their wishes.
  • Provide support and referrals for future and estate planning, participating in meetings with individuals, families, guardians, and teams to offer guidance.
  • Collaborate with individuals and their teams to identify community-based resources and assist with application and referral processes.
  • Ensure compliance and eligibility of services by overseeing service documentation.
KNOWLEDGE, SKILLS, AND ABILITIES:
  • In-depth understanding of SSA benefits and requirements, including SSI, SSDI, Wages/Impairment Related Work Expenses (IRWE), and Medicare Parts A, B, C, D.
  • Comprehensive knowledge of the SSA Representative Payee program, including guidelines and reporting procedures.
  • Thorough familiarity with community and waiver-based Medicaid programs.
  • Strong understanding of DDA Community Pathways and other waiver programs, including the waiver eligibility process.
  • Experience in futures planning assistance, including ABLE accounts and Special Needs Trusts.
  • Preferred: Certification as a Benefits Planner or the ability to complete the certification program successfully.
  • Proficient in technology and software, particularly Microsoft Office Suite.
  • Exceptional written, verbal, and non-verbal communication skills.
  • Demonstrated cultural competency and responsiveness.
  • Ability to adhere to agency requirements, including audits, policies, and procedures.
EDUCATION AND EXPERIENCE:
  • Associate's degree in Psychology, Social Work, or a related Human Services field is required; Bachelor's degree is preferred.
  • A minimum of three (3) years of experience in claims and benefits eligibility is required.
  • Proficient experience with technology and software, particularly MS Word, Excel, and Outlook.
  • Familiarity with insurance terminology and relevant acronyms is essential.
REQUIRED CONDITIONS OF EMPLOYMENT:
  • Ability to lift and/or move up to 50 pounds.
  • Capability to bend, kneel, push, and pull as needed.
  • Eligibility for employment within the United States, with appropriate documentation provided on the first day of employment.
  • Possession of a valid driving record and access to a reliable vehicle.
  • Compliance with training requirements as mandated.
  • A clean criminal history is required.
  • Successful completion of a drug screening is necessary.
  • COVID-19 Considerations: Ardmore Enterprises has implemented a mandatory COVID-19 vaccination policy. All employees are required to be vaccinated unless a religious or medical exemption is requested.