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Public Assistance Eligibility Analyst

2 months ago


Sanford, Maine, United States State of Maine Full time
Department of Health and Human Services (DHHS)
Job Class Code: 5073
Grade: 19 (Professional & Technical Services)
Salary: $22.63-$27.49/hourly*
*Employees in this classification begin at Step 4 of the pay scale

Core Responsibilities:

The role of the Eligibility Specialist involves assessing initial and ongoing eligibility for various public assistance programs. This position may also engage in quality assurance tasks by reviewing eligibility decisions made by others. The work environment is dynamic and demands high standards for customer service and program precision. The specialist collects sensitive and personal information to ensure timely and accurate eligibility assessments. Strong interpersonal and conflict resolution skills are essential as the Eligibility Specialist interacts with individuals from diverse backgrounds and emotional states. Much of the work occurs in a call center setting.

Typical Duties:

• Conduct interviews with clients to gather and evaluate all necessary facts, data, supporting information, and documentation related to applications or recertifications for public assistance.

• Assess information and apply applicable standards and criteria.

• Clearly explain program eligibility requirements, rules, regulations, and individual rights and responsibilities to clients.

• Review and analyze information for accuracy; identify inconsistencies; request necessary documentation; verify and validate data.

• Respond to inquiries and direct clients to various programs.

• Identify potential benefit overpayments, assess the cause for overpayment, and refer for recovery of benefits.

• Detect potential fraud and refer cases to the Fraud Investigation Recovery Unit.

• Accurately input data into an automated system to ensure correct eligibility outcomes.

• Communicate effectively in both verbal and written forms with clients, colleagues, and other agencies.

• Perform intermediate mathematical calculations.

• Uphold confidentiality of all applicant and recipient information.

Minimum Qualifications:

To qualify, candidates must possess a four (4) year combination of education, training, and/or experience in providing direct assistance to individuals or groups or determining client eligibility in a business, legal, or social services context that demonstrates interviewing and data gathering skills for making eligibility determinations, claims resolution, transaction processing, insurance coverage, and/or customer service requests - OR - a Bachelor's Degree in social services, public or business administration, or related fields.

Agency Information:

The Department of Health and Human Services (DHHS) is committed to enhancing health, safety, resilience, and opportunities for the people of Maine. The Department provides health and social services to a significant portion of the State's population, including children, families, older individuals, and those with disabilities, mental health issues, and substance use disorders. The Department also promotes public health and oversees health care providers.

The Office for Family Independence is responsible for managing eligibility determinations for several programs, including MaineCare, Temporary Assistance for Needy Families (TANF), Food Supplement, Fraud and Recovery, and Child Support.

Benefits of Working for the State of Maine:

Employees across Maine state government embody the state motto - "Dirigo" or "I lead" - as they provide essential services to the community. The State is dedicated to supporting the health and wellbeing of its workforce with a comprehensive total compensation package, including:
  • Work-Life Balance - Enjoy 13 paid holidays, 12 days of sick leave, and over 3 weeks of vacation leave annually, with vacation leave accrual increasing with years of service.
  • Health Insurance - The State covers 85%-95% of employee-only premiums, depending on salary.
  • Dental Insurance - The State pays 100% of employee-only dental premiums.
  • Retirement Plan - The State contributes 13.29% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).
  • Parental Leave - All employees welcoming a child receive six weeks of fully paid parental leave.
State employees are eligible for an extensive and competitive benefits package, covering various aspects of wellness.

As an Equal Opportunity employer, Maine State Government fosters a culture of respect and awareness, ensuring an inclusive environment for applicants of all backgrounds.