The Assistant Medicaid and Intake Specialist for Homecare Services supports Medicaid and intake operations specifically related to in-home care programs. This role involves assisting clients and their families with Medicaid eligibility, enrollment, and ongoing support to ensure access to homecare services, along with supporting the intake department in case acceptance and referral management. The position requires an understanding of Medicaid policies, homecare regulations, and a commitment to helping clients maintain their independence at home.
Responsibilities
Medicaid Eligibility and Enrollment
- Assist clients in completing Medicaid applications for homecare services.
- Verify Medicaid eligibility requirements, including financial and medical documentation.
- Work with families and caregivers to explain Medicaid homecare benefits and coverage options.
Compliance and Documentation
- Ensure compliance with state and federal Medicaid regulations specific to homecare.
- Maintain accurate client records, including service authorizations and eligibility updates.
- EPaces review for all current and new Medicaid clients. For existing clients on the 1st and 15th of the month.
- Reports on all non-eligibility to service delivery team
Client and Family Support
- Act as a liaison between clients, families, managed care and Medicaid offices to address questions and concerns.
- Help clients navigate Medicaid programs for personal care services, long-term care, or other homecare benefits.
Program Coordination
- Support Medicaid Coordinator in managing homecare service approvals and renewals.
- Coordinate with homecare providers to ensure clients receive appropriate services under Medicaid guidelines.
Client Authorization
- Monitors HRA LTCW to identify expiring M11Q.
- Requests client M11Q before expiration date.
- Monitor HHX exchange web site on a daily basis to retrieve new cases.
- Completes necessary tasks to reconcile the Billing Edit Report weekly.
- Performs necessary tasks to obtain expiring authorizations.
- Performs necessary tasks to obtain expiring M11Q.
Intake/Referral Management
- Monitors HHH exchange web site on a daily basis to retrieve new cases.
- Coordinates start of care with other departments, as needed.
- Reviews and accepts all new incoming referrals.
- Forwards client information to the respective coordinator on the same day of receipt.
- Monitors fax and email hourly to ensure all new referrals are received and acted upon timely.
- Performs initial contact with client/family to introduce the agency’s services and confirms client’s emergency contact information.
Qualifications
- High school diploma or GED required; an associate degree in healthcare administration, social work, or a related field is preferred
- 1–2 years of experience in Medicaid, homecare services, healthcare administration, or social work.
- Knowledge of Medicaid waiver programs and long-term care services is a plus.
- Strong interpersonal skills and empathy for individuals with healthcare needs.
- Proficiency in Medicaid software systems and Microsoft Office Suite.
- Ability to multitask and manage multiple cases simultaneously with attention to detail.
- Compassionate and client-focused approach.
- Problem-solving and critical-thinking skills, especially in navigating Medicaid regulations.
- Commitment to ensuring access to quality in-home care services for underserved populations.
Work Environment
- Office setting, remote work options, or homecare agency environment.
- Occasionally travel to clients’ homes, Medicaid offices, or provider locations as needed.
Reports to: Intake Supervisor
Classification: Non-Exempt
Salary Range: $40,000 – $42,500
SCS offers an excellent benefits package:
Comprehensive medical, dental and vision insurance
403(b) retirement plan with employer contribution
Flexible spending account and transit benefits
Employee Assistance Program
20 days of paid vacation and 12 paid sick days per year
10 paid holidays
Five personal/floating days
Life insurance
Long-term disability
Dynamic and safe work environment
How to Apply
Email a cover letter and resume to Melissa Vitale, Director of HR, at MVitale@scsny.org. Please indicate “Assistant Medicaid/Intake Specialist” in the email subject line.
All positions at Sunnyside Community Services are filled without regard to race/color, religion/creed, national origin, age, sex/gender, sexual orientation, gender identity or expression, disability, pregnancy-related condition or lactation, military/veteran status, marital status, familial status, caregiver status, sexual or reproductive health decisions, height, weight, status as a victim of domestic violence/stalking/ sex offenses, predisposing genetic characteristic, immigration or citizenship status, prior arrest or conviction record, credit history, salary history, unemployment status, pre-employment marijuana testing, union affiliation/activity, or for reporting or opposing discrimination on these bases or for reporting or opposing violations of workplace health and safety, pay equity or practices, or for participating in any internal o any legally protected status listed in the New York City Human Rights Law (NYCHRL). All are encouraged to apply.
Sunnyside Community Services strives to address, explore, and educate all our stakeholders about the diversity of human experience and to advance and integrate racial equity and social justice into all organizational policies and programs. We believe that everyone, regardless of who they are or what they do for the organization, should feel equally involved and supported. Sunnyside Community Services represents a commitment to considering the whole person and how systemic barriers and access to opportunities can affect their well-being.
Equal Opportunity/Affirmative Action Employer