Eligibility Specialist- Adult Unit

Alamosa County, Department of Human Services, Eligibility Specialist-Adult

JOB SUMMARY:  

Determines initial and continuing eligibility for Health First Colorado (Medicaid), Food Assistance/SNAP, and Aid to the Needy Disabled (AND) Programs.

ESSENTIAL JOB FUNCTIONS: (The following are illustrative of essential functions to perform duties and responsibilities of the job.  The position may not be required to perform all duties listed, and may be required to perform additional tasks as needed by the Department. Reasonable accommodations, as defined under the American with Disabilities Act, will be made when possible.) 

• The work entails the processing of application provided by applicant and verification of information in order to approve or deny assistance based on program eligibility requirements as outlined in state rules and regulations criteria relevant to the initial and continuing eligibility for food assistance/SNAP, financial assistance, and/or medical assistance.  Verification is done by direct contacts, phone, email and or home visits.
• Informs the applicant/recipient of the relevant requirements and benefits of programs for which they may have eligibility. Clarifies and interprets to the clients his/her appeals rights and procedures in response to notices generated by CBMS. Assists and guides the applicants in completing forms, securing the documents and other verifications needed in completing their application and at recertification.  On an ongoing basis, informs recipients of changes on the law or regulations which affect their continuing eligibility and/or the amount of their grant.
• Approves or denies application. Informs applicants within the appropriate time frame and in terms they can understand the approval or denial of their application and on- going changes.
• Interfaces on a daily basis in the County Benefit Management System (CBMS), requiring accurate and complete data entry. Interprets and evaluates computer generated data to determine accurate application to individual case processing for approvals, changes, denials, discontinuations and or case closures.
• Instruction is received on regulations and policies with supervisory consultation on the more difficult application. Selected cases are viewed during the month for completeness, accuracy, and compliance to policy and procedure.  Employees must exercise prudent judgment in applying rules and regulations and ensuring that all information on recipients is accurate and verified.
• Determines the need for recovery of funds or referral for fraud investigation.  Completes informational reports to the proper investigative source for suspicion fraud. Verifies the pertinent statements given the agency by phone contacts, written requests, and/or direct contact with collateral resources. Prepares for and testifies at evidentiary or other administrative hearings.
• Provides information and assesses need for referral to services staff. Makes referrals to other community agencies for available services or assistance such as housing and clothing.
• Errors in determinations could impact recipient grants and claims/recovery to the county.
• Ability to work schedule as set by supervisor.
• Ability to follow policies and procedures of the County and State Department.
• Ability to work well in a team or work independently as required.
• Ability to communicate (verbally & in writing) in English and Spanish (preferred).
• Ability to meet the physical requirements listed below.

REQUIRED QUALIFICATIONS:

Knowledge:

• Knowledge in interviewing clients to obtain necessary information.
• Knowledge and understanding of confidentiality/privacy standards.
• Knowledge of community resources to assist clients.
• Negotiation skills to facilitate an agreement.
• Be proficient in Microsoft Office

Skills :

• Computer skills to perform job tasks.
• Learn and operate computer software specific to DHS programs.
• Skill to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Skill to compute rate, ratio, and percentages.

Abilities :

• Ability to efficiently communicate in English, both written and verbal.
• Ability to maintain sensitive and confidential information.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to apply common sense understanding to carry out instructions furnished in written and oral form.
• Ability to conduct research, to verify information and reconcile financial data.
• Ability to interpret routine reports and maintain required documentation.
• Ability to prepare documentation for Administrative Court hearings.
• Ability to work in a fast-paced time sensitive environment.

EDUCATION, CERTIFICATES, LICENSES, REGISTRATION:

• High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
• Valid Driver’s License. 
• Upon completion of training for Medicaid and Food Assistance worker must be able to pass the Colorado Benefit Management System (CBMS) test through the State SDC training system. This is required to gain system access.

PHYSICAL REQUIREMENTS, WORK CONDITIONS AND ENVIRONMENT:

The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions. Minimal physical effort generally
required in the performance of duties under typically office conditions. Position requires the ability to
operate a computer keyboard at an efficient speed. This may involve repetitive hand movements and
fine coordination. The employee is frequently required to use hands to finger, handle, or feel objects,
tools or controls, and to reach with hands and arms. The position is required to stand, sit for long
periods of time, talk and hear. Hearing and vision correctable to normal ranges; close-up vision and the
ability to adjust focus across an audience. Occasionally, the position may stoop, bend, kneel, crouch,
carry, twist and push and/or pull light to moderate amounts of weight. The employee is required to
communicate both orally and in writing. Employee must be able to reach and manipulate objects, tools or controls, and lift (no more than 25 pounds). The noise level may be very quiet to noisy depending on
the situation. On occasion it may be required to drive in a variety of weather conditions both locally and
throughout the state.

The statements contained herein reflect general details as necessary to describe the essential functions
of this job, the level of knowledge, skills and abilities typically required, and the scope of responsibility,
but should not be considered an all-inclusive listing of work requirements. Individuals may perform
other duties as assigned, including work in other functional areas to cover absences or relief, to equalize
peak work periods, or otherwise to balance the workload.

It is the policy of Alamosa County to not discriminate against any person with regard to all federally
protected classifications including race, color, religion, sex (pregnancy, sexual orientation and gender
identity), age (over 40), national origin, marital status, any disability, genetic information and testing,
family status or any other applicable status protected by federal, state or local law.

This job description does not constitute an employment agreement between the employer and the
employee and is subject to change by the employer as the needs of the employer and requirements of
the job change.