Benefit Programs Specialist II
About The Position
The Benefit Programs Specialist II is the full-performance level in the Benefit Programs Specialist occupational group. The position determines and re-determines individuals’ and families’ eligibility for financial assistance, food stamps, medical assistance, and other social services benefit programs. Work follows established policies, procedures, and guidelines, with independent judgment used for aspects of eligibility determination, particularly when evaluating social factors. Supervisory assistance is sought for difficult or unusual situations. This role specializes in Medicaid Long-Term Care (LTC) casework. The position interviews applicants and recipients, gathers and verifies information, assesses eligibility and benefit levels, maintains case records, monitors changes in circumstances, explains programs and client rights and responsibilities, and makes referrals to appropriate services and agencies. It also identifies potential fraud and discrepancies, evaluates income and other resources, and performs related calculations and reporting.
Requirements
- High school diploma supplemented with experience in benefit programs and completion of required Benefit Programs training, or an equivalent combination of training and experience that provides the required knowledge, skills, and abilities.
- Working knowledge of mathematics for calculating percentages, formulas, and averages.
- Working knowledge of interviewing techniques, including data collection and investigation.
- Working knowledge of public service organizations, economic and basic human behavior, financial assistance programs, and eligibility regulations and guidelines.
- Experience providing customer service to the public, including interviewing and gathering information.
- Skill operating a personal computer and associated office and agency software to research, scan, retrieve data, create and manipulate reports, and establish, process, and maintain case records.
- Ability to communicate effectively orally and in writing with customers, employers, courts, medical professionals, and others.
- Ability to interview clients, gather information, reevaluate situations, and make referrals.
- Ability to determine ownership shares and perform mathematical computations.
- Ability to analyze information from multiple sources and identify missing information and gaps.
- Ability to use automated technology to maintain case records and access data, reports, and information such as estates, retirement accounts, and real estate.
- Ability to maintain confidentiality and professional ethics; exercise sound judgment, discretion, tact, and resourcefulness; and establish effective working relationships in sometimes stressful situations.
Nice To Haves
- Experience evaluating and processing SNAP, TANF, and Medicaid cases.
- Experience with VaCMS, MMIS, or other VDSS agency-related software programs.
- Bachelor’s degree in human services, public administration, sociology, or a related field.
- One to two years of experience processing Medicaid LTC casework.
Responsibilities
- Interview applicants and recipients, obtain necessary information, and re-determine continuing eligibility.
- Explain benefit programs and determine reasons and needs for assistance.
- Process applications for financial assistance and diversion; determine eligibility and benefit levels using automated systems and manual methods.
- Interpret policies and procedures applicable to social services benefit programs.
- Monitor cases for changes in recipient circumstances and implement appropriate benefit-level changes within guidelines.
- Evaluate clients’ employability status and explore potential sources of income.
- Explain client responsibilities, rights, and available programs.
- Refer clients to service workers or Social Workers based on assessments and discernible social problems.
- Prepare reports and maintain client records.
- Identify possible fraud and make appropriate referrals.
- Evaluate information for consistency and completeness and substantiate its accuracy when indicated.
- Compute assistance plans and determine allowances for special circumstances, such as household equipment.
- Provide information about other agencies and services as needed.
- Explain programs under the social services umbrella, including employment services, child support services, and child care services.
- Specialize in Medicaid Long-Term Care casework.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
