ELIGIBILITY SPECIALIST I

ELIGIBILITY SPECIALIST I - 60044953

Families in need and in crisis require time sensitive actions from strong, compassionate individuals who are dedicated to assisting the vulnerable and promoting strong self-sufficient families. This demanding and challenging career could be your opportunity to help those in need make a better life for themselves and their families. Every minute and every case processed count for those who are hungry, caring for others, in need of assistance to provide shelter for loved ones, or just need a helping hand, and your career choice could make a critical difference by making a tremendous impact on countless lives. If you are interested in making a difference, please join our TEAM!

The primary function of an Eligibility Specialist involves determining the eligibility of applicants and recipients for government assistance programs. The work performed includes processing data from electronic sources and entering information into a computer-based eligibility system under state and federal requirements. Eligibility workers are expected to handle a high volume of work which is deadline driven. Workers must be able to prioritize, plan and project their work, while remaining flexible to frequent changes in the program policy and/or computer-based systems.

The duties of a typical day are as follows:

• Interviewing applicants to obtain and verify information needed to determine eligibility for Food Assistance, Medicaid, and Cash Assistance.
• Learning numerous state and federal program regulations, through intensive training prior to full case assignment and then ongoing training thereafter.
• Instructing clients in completion of various forms, and reviewing the applications and forms submitted for completeness and accuracy.
• Determining program eligibility in accordance with current regulations using a computer-based eligibility system.
• Researching information provided by an applicant until satisfactory explanations regarding eligibility status is confirmed.
• Reporting cases where identity theft or fraud is suspected.
• Advising clients of deadlines, time frames, and necessary actions to be taken.
• Working with clients who may not take the necessary actions within the required time frame.
• Establishing and maintaining multiple electronic files and conducting regular reviews and updates.
• Documenting all communications and contacts with clients.
• Managing an electronic caseload that varies based on the community needs, ensuring that accuracy levels are maintained, and cases are processed within the specified time frames set by federal and state regulations.
• Computing and authorizing government assistance benefits based on financial and family status.
• Reviewing and explaining the monthly benefit amount to the customer.
• Staying current with changes in rules, laws, procedures, etc. that affect timeliness and accuracy.

This position may require face-to-face contact with clients.

Qualifications: Two years or more of customer service, interviewing, recruiting, investigating, accounting, processing insurance policies or determining eligibility. OR Associate degree, or higher from an accredited college or university, OR 60 semester hours or 90 quarter hours can substitute for the experience. (When applying please attach required education, certification, or licensure). Ability to attend an 8 - 12-week mandatory training course.

Knowledge, Skills, and Abilities: Apply the laws, rules, and regulations governing eligibility and grant determination for multiple government assistance programs and the case administration of these programs. Ability to review images such as pictures or handwritten notes to make eligibility determinations based on the information provided. Communicate with others to obtain and verify information concerning eligibility. Detect and evaluate potential fraudulent situations. Analyze and interpret written, numerical, and verbal data from various sources. Enter data accurately into a computerized system. Navigate through computer screens, complete, and review basic computer documents and other forms. Plan and organize caseload to ensure work is completed in accordance with regulations relating to eligibility and timeliness. Read, understand, apply complicated and detailed regulations, and policy directives. Perform a variety of mathematical computations accurately and rapidly. Establish and maintain cooperative working relationships with the public and staff. Use computers and related software packages. Follow written and oral directions and instructions.

Candidate Profile (application) must be completed in its entirety. Include supervisor names and phone numbers for all periods of employment. Account for and explain any gaps in employment so that the hiring process is not delayed. Experience, education, training, knowledge, skills and/or abilities as well as responses to pre-qualifying questions must be verifiable to meet the minimum qualifications. It is unacceptable to use the statement "See Resume" in place of entering work history.