Eligibility Worker

Selection Process: Open until filled. Applications will be reviewed as recieved.

JOB SUMMARY:

Eligibility Workers are responsible for the initial and ongoing eligibility and issuance of benefits for financial assistance programs and services. The Eligibility Worker communicates program requirements, assists in understanding eligibility, provides education, makes referrals to other community resources and ensures the integrity of the financial assistance programs and services. ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE THE FOLLOWING. OTHER

RESPONSIBILITIES AND DUTIES MAY BE ASSIGNED.

Administer eligibility determination for federal and state public assistance. * Conducts complex case evaluations and extensive personal interviews with clients for purpose of assessing eligibility. * Explains application procedures to individuals or groups and answers questions on how to complete application forms. * Determines eligibility, and recertification, of benefits for financial assistance programs in accordance to federal, state and local laws, policies and procedures. * Analyze client provided information to calculate benefit amount based on program requirements.

• Independently authorizes expenditures of state and federal dollars.
• Complete all determinations within timelines set by state/federal

regulations.

• Makes appropriate referrals to other services.
• Interpret legal documents, medical documents, health insurance policies,

income tax documents, pension plans, stocks, bonds, burials, annuities, and trusts to determine how this affects eligibility. Provide ongoing case management. * Maintains complete and accurate records on client’s eligibility for all assigned programs to meet state and federal requirements of Department of Human Services quality control and program compliance audits.

• Communicates client changes that are considered vital to appropriate staff.
• Informs clients of eligibility status, refers to programs and other community

resources, guide to self-support.

• Composes correspondence and constructs reports.
• Resolve Income Eligibility Verification System, PARIS, and new hire matches

timely. Adjust benefit amount or close the case.

• Authorize, educate, and enforce the county healthcare access plan.
• Assists clients in resolving health plan problems, investigating issues and

providing resolution. * Impose sanctions or disqualification for clients out of compliance. Determine cost effective insurance by analyzing health insurance policies.

• Determine eligibility for monthly Medicare premium reimbursement.
• Authorize payments to reimburse the client.

Prepare and participate in appeal hearings and complete case action as needed. * Prepares testimony, case documentation, financial calculation and exhibits for hearings.

• Review complex situations with county attorney.
• Testify to appeals judge on policy and procedures.

Identify potential fraud, provide data and information to law enforcement and County Attorney’s Office, and prepare cases for administrative disqualification or prosecution. Recreate budget to determine overpayments and authorize recoupment of funds. Administrative Duties * Clarify and explain information on financial programs to other agency staff, County Board, clients, potential clients, attorneys, authorized representatives.

• Represent agency at request of agency Director or County Board.
• Research and interpret policies and regulations established by legislative

statutes and MN Department of Human Services Rules for the purpose of determining eligibility programs. * Participate in professional staff development, training sessions and meetings to remain current regarding legislative, policy, and procedure changes in financial assistance program requirements.

• Provide excellent customer service.
• Other duties as assigned.

FREEDOM TO ACT AND PROBLEM SOLVING

Eligibility Worker is responsible and accountable for eligibility determinations for various financial assistance programs in accordance with local, state, and federal regulations. The eligibility worker must accurately interpret and apply policy and procedures as outlined in various manuals, DHS bulletins and statutes. Eligibility Worker must exercise professional judgement, critical thinking, and in-depth analysis of information collected from clients and data sources to ensure program integrity. Eligibility Worker is responsible to prioritize and organize tasks to ensure performance standards are achieved. The Eligibility Worker has the freedom to make eligibility decisions for all financial assistance programs and collaborates with the financial assistance supervisor or lead eligibility worker on complex cases and policy.

JOB RELATIONSHIPS:

Internal interactions with: Collaborates with all departments/staff within Human Services. External interactions with: Community partners, public, Attorneys, Department of Employment and Economic Development, Workers Compensation, medical providers, Public Health, court services, law enforcement, Social Security Administration, Internal Revenue Service, financial institutions, employers, employment services, community action partnerships, housing agencies, schools, other local and state agencies.

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and/or Experience: Two years of study from an accredited two- or four-year college with emphasis in behavioral science, business or closely related subjects; or two years of clerical experience in a social services/human services agency; or three years of clerical experience and/or experience working with the public; or a Technical College Human Services Eligibility Worker Diploma; or equivalent combination of education and experience. Language Skills: Ability to read, analyze and interpret diversified, complex data, legal documents, IRS forms, insurance information, technical procedures, government regulations, etc. Ability to write reports, business correspondence and policy/procedure manuals. Ability to effectively interview clients, present information and respond to questions from groups of managers, customers and the public. Multilingual skills are beneficial. Mathematical and Computer Skills Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages. Ability to use state and county computer systems (e.g. Microsoft Office, MAXIS, MMIS, METS, PRISM, ISDS, SIR, EDMS, AVS, SMI, DEED, WF1 and Bluezone Scripts). Ability to use/operate office equipment such as computer, telephone, fax machine, copier, printer, scanner, and miscellaneous department tools and equipment. Reasoning Ability: Considerable ability to solve complex problems and deal with varied situations where only limited standardization exists. Ability to interpret a variety of complex policy and procedures furnished in written, oral, diagram, or schedule form. To remain objective and non-judgmental and to complete work accurately and timely in accordance with state and federal regulations. Ability to handle confidential information and follow data practices requirements. Ability to thrive in ambiguous, fast paced, demanding, and constantly changing work environment while maintaining strong critical thinking, communication and organization skills. Employee is responsible and accountable for daily determinations of eligibility and benefit/grant decisions. The ability to correctly assess and utilize federal, state, and local dollars to prevent lost revenues and federal sanctions. The agency encourages employees to look for creative means to improve service delivery. Employee's professional knowledge and judgment are relied on heavily by the Agency. Physical Demands: The physical demands 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. Positions in this job typically require sitting, walking, standing, driving, talking, hearing, typing, repetitive movement, and seeing. There is exposure to computer keyboards and computer screens. The employee must occasionally lift and /or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, and color vision. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. There is exposure to hostile, despondent, uncooperative persons, and persons with numerous needs, which may result in exposure to offensive language and mental stress and effort. The ability to assess and diffuse these situations is essential. This position works under high attention to details and deadlines. The noise level in the work environment is usually moderate. Renville County Benefits Information: [