Entitlements Specialist/Ombudsman 22-12-04/7/23/12
Institute for Community Living - Brooklyn, NY

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DESCRIPTION

JOB SUMMARY:
Under the general supervision of the Program Director, ensures each resident obtains entitlements clearance at intake. Coordinates benefit application process with Social Services Case managers, carrying out of assignments that include the processing, maintenance and completion of the following job tasks and responsibilities:

ESSENTIAL TASKS:
To perform this job successfully, an individual must be able to perform each essential duty listed satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions unless this causes undue hardship to the agency.

ENTITLEMENTS COORDINATOR DUTIES:A.MAINTAIN ENTITLEMENT CASE RECORDS:
1. Maintains Entitlement client case records in a timely and accurate manner - the up-to-date filing of all incoming entitlement correspondence, inter- and intra-agency documents and information documents relating to the resident's entitlement case.

2. Maintains an up-to-date and accurate written record, in the Contact Notes section of the client case record, of all Entitlement interactions with residents, and with all the entitlement systems, and inter- and intra-agency contacts pertaining to the resident's entitlement case.

3. Utilizes the Entitlement case record as an analytical tool to be able to efficiently access entitlement information when problems arise and for other purposes, e.g., statistical surveys, departmental reports, etc., and is able to use this resource to problem solve and to present this information for supervisory review.

4. Archives hardcopy files in compliance with records retention policies.

5. Maintains any and all additional ICL Entitlement forms and procedures that may be developed to enhance the full range of maintenance of case records task.

B.MAINTAIN THE MONTHLY LEVEL II RESIDENCE ENTITLEMENTS ACCOUNT RECORD AND ANY ADDITIONAL ACCOUNTING PROCEDURES THAT ENSURE THAT ALL THE CLIENT'S BENEFITS ARE ACTIVE AND IN PLACE:

1.Maintains an accurate and up-to-date monthly Entitlements program account book in IMA. This will be accomplished by the timely recording of all incoming entitlement funds that finance a resident's program fees plus PNA amounts.

2.Utilizes this account record as an analytical oversight tool to ensure ongoing receipt of client eligible entitlement funds and to monitor the flow of client entitlement funds.

3.Maintains accurate and up-to-date Direct Deposit records of SSA eligible Level II consumers. The Specialist is responsible for timely processing all necessary paper work for opening and closing Direct
4.Provides technical assistance to consumers and their case managers and maintains the necessary financial records and required procedures to ensure that all Surplus Medicaid cases in both Level II and SH programs are kept in an active state. The attention is particularly important in SH programs where the consumer must make monthly repayments to ICL for any Surplus loan that may have been made to the consumer to access six (6) month Surplus coverage.

5.Maintains any and all additional ICL forms and procedures that may be developed to enhance these recording and analytical tasks.

C.MAINTAINS AND UPDATES THE LATEST IN ENTITLEMENT BENEFITS AND PROCEDURES

THROUGH THE USE OF THE INTERNET AND OTHER RESEARCH TOOLS:
1.The Specialist is fluent in the use of the major entitlement benefit web sites in order to access and research specific entitlement benefits information.

2.The Specialist is familiar with and able to readily use The Public Benefits Research Center (PBRC) Manual as a research tool in order to access New York State entitlement benefits and location information in the ongoing management of his or her consumer cases.

3.The Specialist is able to utilize and integrate any new entitlements information accessed through the use of electronic and other media (such as: PDR - the Physician's Desk Reference, POMS - the collection of SSA rules and regulations, HRA Policy Directives), in his or her ongoing case management activities.

4.The Specialist is able to utilize any type of resources in order to prepare presentations for consumers and clinical staff.

5.Maintains the electronic data system and uses e-mail service on a daily basis.

D.MAINTAINS DAILY CLOSE INTERDEPARTMENTAL RELATIONSHIP WITH THE VARIOUS ICL DEPARTMENTS AND IS ABLE TO FULLY UNDERSTAND AND PROCESS THE FINANCE REPORTS AND THE ADDITIONAL FORMS AND PAPERWORK THAT ARE REGULARLY ISSUED:

1.The Specialist is able to read and understand the following regularly ICL - issued reports

1.and is able to integrate the reported information into his or her ongoing case management activities:
2.Aging Report
3.Overpayment Report
4.Rent Arrears Report
5.Annual Progress Report (APR) for government-funded residential programs.
6.Any additional statistical reviews and reports that may be regularly issued.

2.The Specialist is able to analyze Finance reports, research individual consumer's information, and determine further actions.

3.Maintains on-going contacts with other ICL Departments such as: Central Access, Corporate Compliance, Quality Assurance, programs staff, clinical managers and doctors to maintain accurate and up-to-date clients' case management activities.

E.DEVELOPS AND MAINTAINS COLLATERAL CONTACTS:
1.Accesses, develops and maintains collateral agency contacts and relationships in order to better receive and process entitlement information and documents so as to maximize the resident's entitlement benefits.

2.Utilizes these collateral agency contacts as an on-going resource for additional entitlement knowledge and as a means of expanding and enhancing the Coordinator's advocacy skills.

3.Communicates in an effective manner, both orally and in writing, with wide range of collateral agencies to initiate, maximize and continue the resident's entitlement benefits and services. Be able to effectively communicate with the highest level of collateral staffs such as: AA to the Director, Supervisor or Manager to ensure the clients' benefits cases are processed timely and in an efficient manner.

4.Serve as a client advocate in front of SSA court and at PA, Medicaid and Food Stamps Fair Hearings. Collect and process all medical documentation and forms used to help ICL consumers during their Hearings.

5.Maintains any and all additional ICL Entitlement forms and procedures that may be developed to enhance these collateral contact tasks.

F.PROVIDES ENTITLEMENT COUNSELING TO RESIDENTS AND CLINICAL STAFF:

1.Maintains regularly scheduled Entitlement counseling periods and meetings for the purpose of providing entitlement outreach and advisement to both residents and staff. Specialist should be able to provide individualized benefits advisement services to consumers, which includes collecting the data, analysis and a recommendation to the individual.

2.Is able to communicate effectively and sensitively with both residents and staff and is particularly attuned to the resident's varied and changing abilities to process the often difficult and complex entitlement information.

3.Serves as a dependable and accurate resource of entitlement information for ICL Management and direct-care clinical staffs. Provide training and on-going technical support to clinical management staff with the new and complicated benefit program: Medicare Part D.

4.Maintains any and all additional ICL Entitlement forms and procedures that may be developed to enhance these counseling and reporting tasks.

G. ATTENDS ALL SCHEDULED SUPERVISORY AND BENEFITS TRAININGS:
1.Actively participates in the supervisory process and is able to utilize supervision by taking direction regarding the daily processing and completion of assigned departmental tasks and in order to enhance and expand the specialist's entitlement knowledge base and the skills necessary to effectively work with residents, agency staffs and the various benefit systems that fund the agency's resident-clients.

2.Attends various benefits training sessions, be able to understand and comprehend the ever -changing Entitlements operation procedures, relay the subsequent information to the co-workers and utilize it in incumbent's day-to-day work.

H. OMBUDSMAN DUTIES:
1.Will act as an intermediary and assist Social Services department in disputes between a client and some outside organizations such as Social Security Administration, Human Resources Administration, and Administration for Children Services etc.

2.Will facilitate/coordinate with Social Service department the training for shelter residents in "Negotiating Life Skills."

I. Performs other job related duties that may be assigned.

QUANTITY AND QUALITY OF WORK STANDARD:
In regard to all the tasks described above, it is recognized that the pressure of work can often be very intense and that it is often impossible for a counselor's work to be completed by the end of the usual workday. Nonetheless, it will be expected that the incumbent, after a certain time and experience on the job (approximately after the initial six to eight months), will be able to make reasonable judgments as to which work tasks should be completed sooner rather than later. In other words, the counselor should be able, at this point, to prioritize their range of tasks. The counselor should be able, therefore, to organize a paperwork and case management triage system and process for themselves that will not jeopardize either a resident's entitlement benefits or the entitlement revenue returns to the agency.

QUALIFICATIONS

MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS:
1. Bachelor's degree (B.A.) plus 2 years experience in social/human services (providing services to individuals with psychiatric disabilities a plus), entitlement or related area of service.

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