CSHCN Eligibility Specialist

TX-HHSC-DSHS-DFPS•Arlington, TX

4d•Onsite

About The Position

Under the supervision of the Children with Special Health Care Needs Services Program Supervisor, provides routine and advanced administrative support necessary to carry out daily program operations for the Children with Special Health Care Needs Services Program (CSHCN-SP) area and greater Specialized Health and Social Services (SHSS) program as needed. Provides information and referral for incoming calls and visitors. Processes eligibility applications for the CSHCN-SP, which includes: reviewing applications for accuracy, interviewing clients, collecting program required verification, and documenting case information in assigned databases. Coordinates successful case disposition and effective client services by referring clients to DSHS medical case managers as needed. Performs duties to support case management efforts of the region, including: entering and retrieving client information into/from assigned databases; and transferring and processing case management files according to the specific records retention policy for each case type. Performs duties under moderate supervision with limited latitude for the use of initiative and independent judgment. May train or mentor others. Performs other duties as assigned. Member of the Incident Command Structure (ICS) in response to public health emergencies. Must comply with HHS, DSHS, and Texas Department of Public Safety applicable policies/procedures/standards. Employee must be able to independently travel throughout the State of Texas and out-of-state to complete essential job functions. This position is office-based, Monday-Friday, 8:00 am - 5:00 pm.

Requirements

Knowledge of: best practices pertaining to office etiquette and administrative procedures.
CSHCN-SP program policy, requirements, and procedures; Medicaid programs and the client eligibility process; related children's health programs such as CHIP, CSHCN-SP, SSI; healthcare delivery systems in Texas; Health Insurance Portability and Accountability Act (HIPAA); agency policies and procedures; best practices pertaining to office etiquette and administrative procedures.
Skilled at: creating and maintaining documents and spreadsheets, planning, prioritizing, and organizing workload; developing, compiling, and analyzing reports; problem resolution and effective decision-making; use of software applications, including Microsoft office products.
Ability to: maintain confidentiality in all agency matters, communicate effectively, verbally and in writing; interpret and apply program policies, procedures, and regulations; establish and maintain effective working relationships with internal and external customers; work in teams and take direction from others; manage multiple tasks and meet deadlines; adhere to DSHS and HHS policies and procedures; function independently and with great initiative in the performance of professional duties.
Valid Class C Texas Driver's License
Two years’ experience delivering customer service to a diverse population.
Two years' experience in using Microsoft Office products (Excel, Outlook, Teams, etc.).

Nice To Haves

Experience managing protected health information in compliance with HIPAA standards.
Experience documenting information in databases or electronic health record systems.

Responsibilities

Provides administrative and technical support services for the Children with Special Healthcare Needs Services Program (CSHCN-SP), Personal Care Services (PCS), Community First Choice (CFC), and other SHSS programs.
Answers and routes telephone calls, takes messages, and greets and directs visitors to the appropriate staff.
Prepares, reviews and maintains program reports and documents utilizing standard office equipment and software.
Maintains filing systems in compliance with applicable state and federal statutes.
Processes and disseminates program and regional correspondence.
Participates in the organization, coordination, and tracking of a wide variety of regional program processes and events.
May train or mentor others.
Processes eligibility applications for the CSHCN-SP program.
Interviews consumers to determine eligibility for services.
Provides eligibility information to internal and external customers.
Inputs information and scans eligibility applications and associated documents into the appropriate database systems.
Documents case activity in compliance with applicable state and federal statutes.
Processes and disseminates related correspondence and documents.
Performs other duties as assigned.
Duties include, but are not limited to, being required to work other than normal business hours in order to respond to public health emergencies and actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response/recovery/Continuity of Operations (COOP) activation--requires completion of at least ICS 100, 200, 700 and 800 and may require an alternate shift pattern assignment and/or location.
Maintain compliance with DSHS Policy, Fleet Operations and Management & Procedures and Standards, and a current valid Texas Driver's License.
Participates in regional assignments/duties/special initiatives.

Benefits

DSHS offers insurance coverage and other benefits available through the State of Texas Group Benefits Plan administered by the Employee Retirement System of Texas (ERS).

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