Social Security and Medicaid Specialist

1 week ago

Lanham, Maryland, United States Ardmore Full time

The Eligibility Benefits Coordinator plays a vital role in facilitating communication between the Finance department, LTSS Coordinator, and Services departments. This position is essential in ensuring that individuals for whom we act as Representative Payee maintain their eligibility for Social Security, Medicaid, and waiver services. The Coordinator will develop a comprehensive tracking system to guarantee that annual reviews are conducted promptly and will oversee the auditing of service documentation to ensure compliance with DDA and waiver standards.

At Ardmore, we are committed to our mission of providing high-quality support services to individuals with intellectual and developmental disabilities, ensuring they are respected and have access to community events, activities, and resources.

KEY RESPONSIBILITIES:

  • Establish and manage a database to track Medicaid waiver recertification, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Medicare, and other relevant resources and assets.
  • Oversee Resident Fund Management System (RFMS) accounts to ensure adherence to Medicaid, SSI, and waiver regulations.
  • Conduct SSA reviews, including annual Representative Payee reports, wage reporting, and documentation of account balances.
  • Assist in transitioning from SSI to SSDI when necessary and facilitate applications for Medicare coverage.
  • Maintain Medicaid eligibility and redetermination for all individuals served under the Representative Payee program, acting as a liaison with Division of Waivers Eligibility Services (DEWS).
  • Collaborate with the Nurse Manager and Delegating Nurse to select Medicare D prescription programs.
  • Track DDA waiver eligibility for all individuals receiving services and assist with waiver redeterminations as required.
  • Support individuals in establishing benefits-protected savings accounts, including Maryland ABLE accounts and Special Needs trusts, while serving as a liaison with relevant entities.
  • Assist individuals in creating irrevocable pre-needs funeral trusts and plans that align with their personal wishes.
  • Provide guidance and referrals for future and estate planning, participating in meetings with individuals, families, and support teams as necessary.
  • Work collaboratively with individuals and their teams to identify community-based resources and assist with application processes.
  • Ensure compliance with service documentation through oversight and monitoring.
REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:
  • In-depth understanding of SSA benefits, including SSI, SSDI, and Medicare.
  • Familiarity with the SSA Representative Payee program, including guidelines and reporting procedures.
  • Comprehensive knowledge of community and waiver-based Medicaid programs.
  • Awareness of DDA Community Pathways and other waiver programs, including eligibility processes.
  • Experience in futures planning, including ABLE accounts and Special Needs Trusts.
  • Preferred: Certification as a Benefits Planner or the ability to obtain such certification.
  • Proficient in technology and software applications, particularly Microsoft Office Suite.
  • Exceptional written and verbal communication skills.
  • Demonstrated cultural competency and responsiveness.
  • Ability to adhere to agency policies and procedures, including audits.
EDUCATION AND EXPERIENCE:
  • Associate's degree in Psychology, Social Work, or a related field is required; Bachelor's degree is preferred.
  • A minimum of three years of experience in claims and benefits eligibility is required.
  • Proficient in technology and software, particularly MS Word, Excel, and Outlook.
  • Familiarity with insurance terminology and relevant acronyms.
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 is required.
  • Must maintain a valid driving record and have access to reliable transportation.
  • Compliance with training requirements is necessary.
  • A clean criminal history is mandatory.
  • Successful completion of a drug screening is required.
  • COVID-19 Considerations: Ardmore Enterprises has a mandatory COVID-19 vaccination policy in place.

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