Eligibility Specialist I

Eligibility SpecialistThe Eligibility Specialist classifications determine the eligibility of applicants and recipients for public assistance programs through interactive interviewing and fact gathering; maintain current knowledge of program regulations and procedures necessary for multi-program caseload administration; initiate and process casework through automated systems; identify needs and make appropriate referrals for health, social, and/or employment services; and perform related work as required. The Eligibility Specialist I is the entry-level classification in the Eligibility Specialist series. Incumbents may have prior experience determining eligibility for loans, financial assistance, unemployment or veterans benefits, or publicly or privately funded health, counseling or social services programs; have completed initial classroom training provided as part of the Eligibility Specialist Trainee training program; or may have the required level of education. Incumbents will be placed in a work team and initially may receive classroom instruction prior to being assigned casework and/or tasks. Incumbents will work under close supervision while learning to independently determine public assistance eligibility, and apply knowledge and skills learned from their training in completing eligibility tasks and applying complex regulations. As incumbents gain experience and work toward the journey level in the series, they are expected to work with more independence and have the ability to complete more complex tasks and/or handle larger client caseloads. Incumbents are expected to progress to the journey-level Eligibility Specialist II upon completion of one year of satisfactory performance in the entry-level Eligibility Specialist I classification. Supervision exercised and received.Incumbents in the Eligibility Specialist I and II classifications typically receive supervision from an Eligibility Supervisor and may receive lead direction from an Eligibility Specialist III.Examples of DutiesDuties may include, but are not limited to, the following:Performs interactive interviews to elicit eligibility information, obtain and/or verify financial, employment, tax and personal demographic information and determine eligibility for public assistance programs and servicesAnalyzes financial and eligibility information to determine initial or continuing eligibility for multiple aid programsExplains regulations, rules and policies to clients and apprises them of their rights, responsibilities and eligibility for participation in various public assistance programs and servicesEnsures accuracy and completion of application and declaration formsResolves discrepancies by securing documentation, medical records and confirmation from other agenciesEnters and retrieves numerical and narrative data and issues benefits from an automated computer systemDetermines the level of benefits to which the client is entitled by making complex computations and/or computer entries and then analyzing the resultsReviews and interprets information provided on a variety of forms both by the client and third parties to assist with eligibility determinationEvaluates clients for and answers questions on Advanced Payment Tax Credits (APTC) related to health care reformExplains a variety of plan options, costs and individual plan features through Covered CaliforniaMonitors on-going eligibility by obtaining periodic updated information of eligibility factors and takes appropriate actions on changesDetermines need for additional services and makes referrals as needed for employment and other services to outside agencies to assist clients toward self-sufficiency and directs clients accordinglyOrganizes and prioritizes caseload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policyEnters and maintains case records, including written narratives, forms and computer documents in a clear and readable formatTroubleshoots task and/or case issues to determine appropriate resolution of problems, involving Help Desk as neededCommunicates both orally and in writing with clients and others related to the initial and ongoing eligibility determination while maintaining confidentialityResponds to questions and complaints of clients in person, by telephone, mail and/or email communicationProvides pertinent forms and pamphlets to clients as requiredIdentifies suspected fraud and makes referrals for investigationMakes referrals to social service workers as neededParticipates in special projects, studies, work assignments and committeesPrepares correspondence and reportsPerforms related duties as assignedEmployment StandardsNote: The level and scope of the knowledge and skills listed below are related to job duties as distinguished between the two levels in the Definition section.Knowledge of:General goals and purpose of public social services programsLaws, rules, regulations, policies and procedures governing eligibility for diverse public assistance programs and related case administrative techniquesMethods and techniques of conducting an investigative interview and information gatheringComputer terminology and computer keyboard arrangementModern office practices, methods and proceduresRecord keeping practices and proceduresPrinciples of mathematical calculationsIntricacies of health insurance plans, medical health plan options and associated terminologyRegulations and rules regarding household filing status related to the Affordable Care ActCultural and human behavior, including knowledge of self, to interact effectively with clients and staffPrinciples and practices of effective customer serviceStructure and content of the English language including the meaning and spelling of words, rules of composition and grammarModern equipment and communication tools used for business functions and program, project and task coordinationComputers and software programs (e.g., Microsoft software applications) to conduct research, assess information and/or prepare documentationAbility to:Apply the policies, procedures and programs of the County Social Services DepartmentApply the laws, rules and regulations governing eligibility and grant determination for multiple public assistance programs and the case administration of these programsIdentify available resources and communicate with others to obtain and verify information concerning eligibilityUse fact finding techniques and perform in-depth and interactive interviewingDetermine appropriate course of action in emergency situationsMake referrals to appropriate agencies and social service programsDetect and evaluate potential fraudulent situationsAnalyze and interpret written, numerical and verbal data from various sourcesUtilize multiple electronic information, social services systems and analyze and interpret such informationEnter and maintain data accurately and timely into a computerized systemNavigate through computer screens and effectively use computer systems, software applications and modern business equipment to perform a variety of work tasksIdentify when computer output is incorrect and make correctionsProcess cases manually as requiredPlan and organize caseload to ensure work is completed in accordance with regulations relating to eligibility and timelinessFunction effectively in a system with strict deadlines and constant changesRead, understand, apply and explain complicated and detailed correspondence, reports, regulations and policy directivesPerform a variety of mathematical computations accurately and rapidlyPrepare clear, concise and accurate records and reportsExplain complex rules and programs so they can be understood by people of diverse socio-economic, cultural and educational backgroundsGather, record and correctly evaluate tax filing data, income and additional necessary information required for the determination of eligibility for one or more programsExplain health insurance plan options and plan details available to clients through the Affordable Care ActReview a variety of tax documents to obtain needed household filing informationExplain health care reform tax credit implications to clientsRefer clients to other community services as neededAssess and manage difficult and hostile persons or situations; or call for intervention when appropriateInteract with people in a courteous manner in person, on the telephone, by mail or emailWork in a fast-paced, professional office environment and prioritize a wide range of duties with varying time requirements to ensure timely completionCommunicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntaxEstablish and maintain cooperative working relationships with the public and staffFollow written and oral directions and instructionsMinimum QualificationsPattern 1: One year full-time experience in an Eligibility Specialist Trainee classification in an Interagency Merit System (IMS) county; OR Pattern 2: One (1) year of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment