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Eligibility Specialist

2 months ago

Sacramento, California, United States Merit System Services Full time
Job Summary

The Eligibility Specialist will play a critical role in determining the eligibility of applicants and recipients for public assistance programs. This position requires strong analytical and communication skills to conduct interactive interviews, analyze financial and eligibility information, and determine initial or continuing eligibility for multiple aid programs.

Key Responsibilities
  • Conduct interactive interviews to determine eligibility for public assistance programs and services
  • Analyze financial and eligibility information to determine initial or continuing eligibility for multiple aid programs
  • Explain regulations, rules, and policies to clients and apprise them of their rights, responsibilities, and eligibility for participation in various public assistance programs and services
  • Ensure accuracy and completion of application and declaration forms
  • Resolve discrepancies by securing documentation, medical records, and confirmation from other agencies
  • Enter and retrieve numerical and narrative data and issue benefits from an automated computer system
  • Determine the level of benefits to which the client is entitled by making complex computations and/or computer entries and then analyzing the results
  • Review and interpret information provided on a variety of forms both by the client and third parties to assist with eligibility determination
  • Evaluate clients for and answer questions on Advanced Payment Tax Credits (APTC) related to health care reform
  • Explain a variety of plan options, costs, and individual plan features through Covered California
  • Monitor on-going eligibility by obtaining periodic updated information of eligibility factors and take appropriate actions on changes
  • Determine need for additional services and make referrals as needed for employment and other services to outside agencies to assist clients toward self-sufficiency and direct clients accordingly
  • Organize and prioritize caseload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policy
  • Enter and maintain case records, including written narratives, forms, and computer documents in a clear and readable format
  • Troubleshoot task and/or case issues to determine appropriate resolution of problems, involving Help Desk as needed
  • Communicate both orally and in writing with clients and others related to the initial and ongoing eligibility determination while maintaining confidentiality
  • Respond to questions and complaints of clients in person, by telephone, mail, and/or email communication
  • Provide pertinent forms and pamphlets to clients as required
  • Identify suspected fraud and make referrals for investigation
  • Make referrals to social service workers as needed
  • Participate in special projects, studies, work assignments, and committees
  • Prepare correspondence and reports
  • Perform related duties as assigned
Requirements
  • High school diploma or equivalent required
  • One year of full-time experience in an Eligibility Specialist Trainee classification in an Interagency Merit System (IMS) county
  • Or one (1) year of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits and two (2) years of clerical work involving public contact
  • Or two (2) years of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits
  • Or four (4) years of full-time clerical work involving public contact, interviewing, math computations, completion of forms, or eliciting information from the public
  • Or graduation from an accredited four-year college or university
Preferred Qualifications
  • Bachelor's degree in social work, public administration, or a related field
  • Experience working with public assistance programs and services
  • Strong communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
  • Proficiency in Microsoft Office and computer software applications
Working Conditions

The Eligibility Specialist will work in a fast-paced office environment and will be required to sit for long periods of time. The position will also require frequent use of a computer and other office equipment.

Benefits

The Calaveras County Department of Health and Human Services offers a comprehensive benefits package, including medical, dental, and vision insurance, retirement plan, and paid time off.