The Enrollment (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
Qualifications and Education Requirements:
- Effectively demonstrates versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
- Effectively collaborates and works within a team, while also effectively demonstrating the ability to take initiative and work well individually
- Intermediate computer skills – MS Office (Excel, Word, Outlook, Teams), Internet, Electronic Health Record, etc.
- Demonstrates a thorough understanding of AHCCCS (Medicaid), CMS guidelines, and current entitlement standards and practices required
- Three (3) years of entitlement experience in a behavioral health and/or healthcare setting or equivalent combination of education, training, and/or experience required
- CPR/FA certification may be required
- CPI certification may be required
- High school diploma or GED required
- Successful clearance of pre-employment criminal/county/state background check
- Successful clearance of pre-employment drug and alcohol testing
- Successful clearance of annual TB PPD testing
Additional Notes:
New Freedom Ops LLC is an Equal Opportunity Employer, a drug free workplace, and complies with Veteran and ADA regulations as applicable.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Professional development assistance
- Vision insurance
Schedule:
People with a criminal record are encouraged to apply
Ability to Commute:
- Phoenix, AZ 85029 (Required)
Ability to Relocate:
- Phoenix, AZ 85029: Relocate before starting work (Required)
Work Location: In person