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The Entitlement Specialist is responsible for educating members about AHCCCS benefits and assisting members with the enrollment process. The Entitlement Specialist actively engages with members to provide the service and support, while also actively monitoring member eligibility, documenting the engagement in a timely, thorough, and accurate manner.
Duties and Responsibilities:
- Educates members about the benefits of active AHCCCS (Medicaid) health insurance, encouraging members to enroll in the AHCCCS plan of their choice
- Assists members with completing AHCCCS applications, as required
- Partners with the appropriate Transitional Services and/or Clinical team staff to ensure members are referred to a different facility if/when they are enrolled in a health plan that New Freedom does not accept
- Partners with the member’s assigned Transitional Services staff to help support the member with obtaining any/all personal documents necessary to activate their AHCCCS enrollment (i.e., state-issued ID, birth certificate, social security card, etc.)
- Obtains the necessary consents/releases of information (ROIs) to assist members with any/all entitlement issues
- Completes member engagement activities on a daily basis, ensuring any/all engagements are documented in a clear, accurate, and timely manner, aligned with the company’s outlined documentation standards and practices
- Tracks AHCCCS eligibility, upcoming changes in insurance status, and/or re-certification dates in a consistent and timely manner
- Maintains any/all relevant documentation for members’ AHCCCS eligibility, saving and/or documenting the documents in the outlined manner
- Stays abreast of current city, state, and federal regulations, laws, and/or initiatives pertaining to entitlements, regularly monitoring available resources, and attending relevant training(s) and meetings
- Complies with program guidelines about DES Nutrition Benefits and Unemployment, refraining from offering or assisting members with requesting SNAP (food stamp) or unemployment benefits
- Provides all services and support in a culturally sensitive, trauma-informed, and recovery-oriented manner
- Assists with additional administrative tasks for Mentorship, Intake, and/or other departments, as needed
- In addition, all other duties as assigned
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At New Freedom, we restore lives and reintegrate communities through intentional guidance by providing our members with a sense of identity, purpose, and hope. We are growing and always looking for others who believe in our mission and have a heart to serve. Join our AMAZING team, apply now! We’re fulfilling our mission thanks to the dedicated work of our amazing employees. We provide them with a valuable total rewards package that includes:
- Competitive pay rates – including shift differential for eligible shifts/positions
- Comprehensive medical coverage (including dependents/family) – majority company-paid
- Short Term Disability, Life Insurance, Employee Assistance Program – company-paid
- 401K
- Dental, Vision, and Supplementary Insurance – available at low cost to employees
- Paid Time Off
- Paid Sick Time
- Paid Holidays – including 2 extra Floating Holidays
- Even more perks provided by the company, include:
- 10-hour shifts with three days off – for eligible departments/positions
- Onsite meals, snacks, and drinks – complimentary for employees
- Onsite gym services – complimentary for employees
- Onsite professional training opportunities/certifications/continuing education
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Additional Notes:
New Freedom Ops LLC is an Equal Opportunity Employer, a drug free workplace, and complies with Veteran and ADA regulations as applicable.
Required
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Effectively collaborates and works within a team, while also effectively demonstrating the ability to take initiative and work well individually
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Intermediate computer skills – MS Office (Excel, Word, Outlook, Teams), Internet, Electronic Health Record, etc.
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Demonstrates a thorough understanding of AHCCCS (Medicaid), CMS guidelines, and current entitlement standards and practices required
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3 year(s): Entitlement experience in a behavioral health and/or healthcare setting or equivalent combination of education, training, and/or experience required
Required
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High School or better
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HS Equivalency or better
Required
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APS Verification
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Criminal Background Check
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CPI Certification
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CPR/FA Certification
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Annual TB Clearance
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Drug & Alcohol Testing
Preferred
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Driver's License
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MVR Clearance
Required
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Ability to sit for prolonged periods
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Effective interpersonal skills
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Computer/Technology Literacy
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Behavioral Health Experience
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AHCCCS/Medicaid, CMS & coding/billing regs
Preferred
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Lived Experience
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Legal/Justice Involvement
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Bilingual (Spanish)
Required
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Functional Expert: Considered a thought leader on a subject
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Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
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Dedicated: Devoted to a task or purpose with loyalty or integrity
Preferred
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Goal Completion: Inspired to perform well by the completion of tasks
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Growth Opportunities: Inspired to perform well by the chance to take on more responsibility
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Self-Starter: Inspired to perform without outside help
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Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization