DSHS ESA Public Benefits Specialist 4

State of Washington • Sunnyside, WA

367d

About The Position

The Public Benefits Specialist 4 (PBS4) serves as lead worker and is expected to possess a high level of proficiency in all public benefit programs. The position is responsible to audit, coach, train and guide lower level Public Benefits Specialists. Also performs case audits/reviews and observational audits. This position will have access to the Washington Health Plan Finder (HPF) system and personally identifiable information (PII). Per the Information Exchange Agreement No. 2013-02 between the Centers for Medicare & Medicaid Services (CMS) and State-Based Exchanges for the disclosure of health insurance affordability programs information under the Patient Protection and Affordable Care Act, passing a criminal background check is required for this position.

Requirements

• Must have exceptional understanding of eligibility, Community Services Division processes and appropriate computer programs (ACES, ACES Online, Barcode, e-Jas, ICMS, Washington Connections).
• Duties require extensive and specialized financial knowledge as well as ability to interpret public laws and policies and the ability to make independent decisions.
• Must possess extensive knowledge of Washington Administrative Code (WAC) and procedural manuals needed to determine eligibility for all programs administered by CSD.
• Must possess excellent communication skills both oral and written and provide outstanding customer service by phone.
• Ability to maintain quality and productivity levels.
• Ability to assist others in interpretation and analysis of data; make independent decisions; supervise and train staff.
• Proficiently utilize all computer programs in use by Community Service Division. Frequently review data found in the State's computer systems to make accurate decisions.
• Stay calm under pressure, and effectively manage the stress of the job.
• Seek clarification of rules, policies and procedures from supervisor, trainers and/or program managers when appropriate.

Nice To Haves

• A Bachelor's degree or Master's degree and twelve (12) months of experience as a Public Benefits Specialist 3.
• A Bachelor's degree or higher and twelve (12) months of experience as a Public Benefits Specialist 2 determining eligibility for long-term care services.
• Equivalent education/experience: Experience examining/processing loan applications, medical insurance or rehabilitation claims, unemployment insurance claims, or a job providing staff support in financial eligibility determination, or in a job analyzing, verifying, and evaluating financial data and information, will substitute year for year, for education experience.
• Satisfactory completion of the Agency's Public Benefits Specialist Training Program.
• Out of state experience, conducting financial eligibility determination for public assistance to include financial, medical and food benefit programs will be considered toward experience.

Responsibilities

• Assigns work to Public Benefits Specialist staff who process cash, medical, and/or food benefits.
• Audits/reviews work of Public Benefits Specialist staff. Conducts ongoing audits for new and experienced staff. Establishes reports and recommendations to supervisor on staff progress.
• Detects error trends through audits to identify training needs.
• Serves as a job coach for staff.
• Maintains and reviews procedures for efficient workflow.
• Performs more complex duties in relation to establishing financial eligibility, rule interpretation, planning, and procedural development.
• Verifies and establishes overpayments and completes referrals to the Office of Financial Recovery.
• Reviews cases and independently analyzes case actions for accuracy. Contacts staff, agencies and the community as necessary for clarifying information.
• Uses basic understanding of the administrative hearing process to review cases and to help decide if a hearing request can be settled prior to submission and assures appropriate action is taken.
• Assists customers with the process of applying for Apple Healthcare by entering information into the Health Plan Finder (HPF) system on behalf of the clients.
• Provides interpretive and translation services for Spanish speaking clients.

Benefits

• Equal opportunity employer.
• Commitment to equity, anti-racism, and social justice.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Administration of Economic Programs
• Education Level: Bachelor's degree