Eligibility Specialist

2 weeks ago

Sacramento, California, United States Merit System Services Full time
Job Title: Eligibility Specialist

Join Merit System Services as an Eligibility Specialist and play a vital role in determining the eligibility of applicants and recipients for public assistance programs. As a key member of our team, you will be responsible for conducting interactive interviews, gathering and verifying financial and eligibility information, and determining eligibility for public assistance programs and services.

Key Responsibilities:
  • Conduct interactive interviews to elicit eligibility information and 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; associate's or bachelor's degree in a related field preferred
  • One year of experience in a related field, such as social services, public assistance, or government administration
  • Excellent communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
  • Knowledge of public assistance programs and services
  • Ability to analyze and interpret data and make sound judgments
  • Ability to work independently and as part of a team
  • Ability to maintain confidentiality and handle sensitive information
Working Conditions:

Work is performed in a standard office environment with occasional travel to other locations. Must be able to work in a fast-paced environment and prioritize multiple tasks.

Benefits:

Merit System Services offers a competitive salary and benefits package, including medical, dental, and vision insurance, retirement plan, and paid time off.

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