Benefits & Entitlement Associate- Community Guardian Program

Shift Schedule: Monday-Friday: 9AM-5PMHours Per Week: 35

General Responsibilities:

The Community Guardian Program (CGP) Benefits and Entitlement Associate is responsible for managing the

full Medicaid eligibility and benefits process for CGP clients, including collecting and reviewing financial

documents, screening for eligibility, filing and tracking applications and conversions, and coordinating with

DSS, MLTC plans, families, attorneys, and financial institutions. The role also resolves issues such as NAMI

calculations, income redirects, fair hearings, and recertifications, ensuring residents maintain appropriate

coverage and that all financial and legal requirements are met accurately and on time.

Primary Responsibilities:

Conduct financial interviews and obtain all required authorizations and documentation for Medicaid applications.Processes all initial applications for benefits and entitlements in a timely manner.Participate in relevant training and seminars to stay informed about current trends and changes within the benefits/entitlements system.Prepare, file, and track Medicaid, Medicare Premium applications, and annual recertifications.Communicate and follow up with CGP and DSS caseworkers; complete budget corrections when needed with CGP case workers.Escort clients to various government and city agencies (Social Security Administration, HRA-Public Assistance, Medicaid and Food Stamp offices.File and attend Medicaid fair hearings when necessary.Educate CGP caseworkers on income obligations, payer requirements, and signature needs.Monitor new developments and remain abreast of public policy issues relevant to changes in client benefits and entitlements.Participate in CGP Interdisciplinary Team meetings to support care planning and discharge needs.

Qualifications:

An undergraduate degree in business, social work, social or human services, or a related field.Strong organizational and documentation abilities.Working knowledge of Medicaid eligibility rules, including income/resource limits, spend-down rules,allowable and non-allowable asset transfers, and documentation requirements.Familiarity with Medicaid and other entitlement applications, recertifications, notices, and workflowsused by HRA and NYS county DSS offices.Understanding of payer sources used in long-term care, including Medicare, MLTC, MMC, privateinsurance, and HMOs.Basic familiarity with guardianship, and representative authority and their relevance to Medicaidapplications.Ability to interpret financial notices, verification requests, and budget calculations issued by DSS/HRA.Understanding of fair hearing processes, including filing, preparation, and support.Prior experience in Medicaid, benefits coordination, or long-term care eligibility required; experiencein long-term care strongly preferred.Computer proficiency, including case management systems.Strong written and verbal communication skills.Ability to interact with families, colleagues, and external partners professionally and courteously.Commitment to equity, inclusion, and cultural competence when serving diverse older adult populations.

JASA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, genetic information, or any other protected classification under federal, state, or local law.

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