ELIGIBILITY COMPLIANCE WORKER

New York City, NY • Brooklyn, NY

120d

About The Position

The Department of Social Services (DSS) is comprised of the administrative units of the New York City Human Resources Administration (HRA) and the Department of Homeless Services (DHS). HRA is dedicated to fighting poverty and income inequality by providing New Yorkers in need with essential benefits such as Food Assistance and Emergency Rental Assistance. DHS is committed to preventing and addressing homelessness in New York City by employing a variety of innovative strategies to help families and individuals successfully exit shelter and return to self-sufficiency as quickly as possible. DSS/HRA Fair Hearing Administration is responsible for providing representation of the Agency at NYS Administrative Hearings in the following program areas: Cash Assistance (CA), Supplemental Nutrition Assistance Program (SNAP), IREA, HASA and MISCA - Medical Assistance (MA). The Office of the General Counsel / Fair Hearing Administration is recruiting for one (1) Eligibility Specialist, Level II to function as Eligibility Compliance Worker for their MICSA Fair Hearing Unit.

Requirements

• Completion of 30 semester credits at an accredited college or university; or
• A four high school diploma or its educational equivalent and one year of full-time satisfactory experience in one or more of the following areas: interviewing, gathering information and/or preparing necessary documentation for the purpose of making recommendations concerning eligibility for public assistance or unemployment, health benefits, social security, insurance, or participation in social services or community programs, and other similar benefits; or performing bookkeeping, bank teller duties, housing office teller duties, purchasing agent, assistant store manager, sales representative responsible for accounts, or customer service duties or a job in which the duties include helping customers with questions or concerns; or dealing with social service agencies, legal representatives, or aiding individuals in navigating housing, social, financial or health problems or application systems.
• A satisfactory combination of education and/or experience equivalent to '1' or '2' above.

Nice To Haves

• Must have extensive background in Medicaid eligibility and be able to complete all MA eligibility transactions in WMS.
• Must be up to date in Medicaid Savings Program and how to accrete a case in the EmedNY system.
• Must be able to communicate well with all consumers and act in a professional manner even when confronted with difficult consumers.
• Must be able to move the interviews along to allow to meet the deadlines imposed by the State OTDA.
• Work well under pressure, as well as, manage the interview process.
• Must be organized, self-sufficient and be an independent starter.
• The worker must be proficient in WMS eligibility actions, understand all budgeting types, understand Edits, Emendy and proficient in working with word and excel reports.

Responsibilities

• Gather information regarding client eligibility for PHI from submitted forms, via face-to-face contact, or via telephone to ensure compliance with State fair hearings decisions.
• Determine PHI eligibility based upon the pertinent laws, rules, regulations, and procedures in order to provide the appropriate action for each Fair Hearing appellant.
• Contact appellants to discuss eligibility and resolve as many cases as possible before the hearing is scheduled.
• Examine and verify client's eligibility information using the WMS and FHIS and examine the client's Aid to Continue (AC) eligibility and its ramifications for the case and instigates voluntary withdrawals from the fair hearing process.
• Process extension of Medical coverage for clients entitled to AC and whose Medicaid eligibility is scheduled to expire or has already expired.
• Process 'clock down' lists by extending coverage for appellants whose hearing have not been scheduled or have been rescheduled.
• Provide information regarding PHI eligibility to current and potential clients via telephone and in person.
• Transmit the required Withdrawal of NYS OTDA Fair Hearing Request form (MAP-316P) to the appellant in instances where the voluntary withdrawal is agreed to.
• Review the MAP-316P form to ensure that it is duly signed and complete upon its return.
• Maintain log of contact with clients, noting issues that have been resolved and cases that have been either resolved or withdrawn.
• Forward the MAP-316P form to the Record Management/Carfare Unit for addition to the appellant's file.
• Prepare daily, weekly, and monthly activity reports for submission to supervisory staff.
• Consult with the Unit Supervisor on overall problems and complicated cases as needed.

Benefits

• Public Service Loan Forgiveness eligibility.
• New York City residency requirement within 90 days of appointment.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Justice, Public Order, and Safety Activities
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees