Job Description

The mission of CARES (Community Assistance Resources and Extended Services, Inc.) is to assist children and adults with intellectual/developmental disabilities (ID/DD) and/or mental health conditions and their families, in particular, from under-served multilingual communities, access information, obtain resources and services.

Salary Range: $50-$60k Location: Bensonhurst, Brooklyn, NY

Essential Duties and Responsibilities:

The responsibilities for the HCBS Authorization team include ensuring that clients and their families get the services they need by providing the necessary support, while adhering to state laws and guidelines.

• Ensure authorization forms are completed properly and submitted in a timely manner to the insurance company.
• Responsible for keeping track clients with issues, what those issues are, and dealing with those issues accordingly including unenrolling clients who are out of compliance.
• Communicate with all parties involved in each case including but not limited to: Insurance carrier, care management department, Referral Services agencies, supervisors, team members, clients and family members.
• Responsible to review all documentation to ensure eligibility and compliance with NYS HCBS Manual and Medicaid Standards prior to submission and service.
• Responsible for personal caseload; client’s must be reviewed on a case-to-case basis and ensuring all related tasks are completed in a timely manner while remaining in compliance.
• Submit appeal requests as clients’ families see fit.
• Documenting every step of the process from beginning to end. Including but not limited to: all communications, insurance notifications, client updates, care management updates, etc.
• Maintain compliance with all company policies and procedures .
• Perform related duties as assigned by supervisor.
• Special Projects as assigned.

Education and/or Work Experience Requirements:

• Must be able to adapt quickly, as the State constantly has new guidelines that will shift the rules and how you review clients cases.
• Knowledge and use of EHR and CARES internal systems and software.
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
• Computer proficiency (MS Office – Word, Excel and Outlook)
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service.
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
• High school diploma or GED required, Associates or Bachelor's Degree preferred.

Physical Requirements:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
• Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
• Must be able to lift 35 lbs.
• Must be able to talk, listen and speak clearly.

Skills Required