Eligibility Specialist- Adult Unit

Alamosa County•Alamosa, CO

7d•$19 - $19•Onsite

About The Position

Determines initial and continuing eligibility for Health First Colorado (Medicaid), Food Assistance/SNAP, and Aid to the Needy Disabled (AND) Programs. The work entails the processing of application provided by applicant and verification of information in order to approve or deny assistance based on program eligibility requirements as outlined in state rules and regulations criteria relevant to the initial and continuing eligibility for food assistance/SNAP, financial assistance, and/or medical assistance. Verification is done by direct contacts, phone, email and or home visits. Informs the applicant/recipient of the relevant requirements and benefits of programs for which they may have eligibility. Clarifies and interprets to the clients his/her appeals rights and procedures in response to notices generated by CBMS. Assists and guides the applicants in completing forms, securing the documents and other verifications needed in completing their application and at recertification. On an ongoing basis, informs recipients of changes on the law or regulations which affect their continuing eligibility and/or the amount of their grant. Approves or denies application. Informs applicants within the appropriate time frame and in terms they can understand the approval or denial of their application and on-going changes. Interfaces on a daily basis in the County Benefit Management System (CBMS), requiring accurate and complete data entry. Interprets and evaluates computer generated data to determine accurate application to individual case processing for approvals, changes, denials, discontinuations and or case closures. Instruction is received on regulations and policies with supervisory consultation on the more difficult application. Selected cases are viewed during the month for completeness, accuracy, and compliance to policy and procedure. Employees must exercise prudent judgment in applying rules and regulations and ensuring that all information on recipients is accurate and verified. Determines the need for recovery of funds or referral for fraud investigation. Completes informational reports to the proper investigative source for suspicion fraud. Verifies the pertinent statements given the agency by phone contacts, written requests, and/or direct contact with collateral resources. Prepares for and testifies at evidentiary or other administrative hearings. Provides information and assesses need for referral to services staff. Makes referrals to other community agencies for available services or assistance such as housing and clothing. Errors in determinations could impact recipient grants and claims/recovery to the county.

Requirements

Knowledge in interviewing clients to obtain necessary information.
Knowledge and understanding of confidentiality/privacy standards.
Knowledge of community resources to assist clients.
Negotiation skills to facilitate an agreement.
Proficient in Microsoft Office.
Computer skills to perform job tasks.
Ability to learn and operate computer software specific to DHS programs.
Skill to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Skill to compute rate, ratio, and percentages.
Ability to efficiently communicate in English, both written and verbal.
Ability to maintain sensitive and confidential information.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to apply common sense understanding to carry out instructions furnished in written and oral form.
Ability to conduct research, to verify information and reconcile financial data.
Ability to interpret routine reports and maintain required documentation.
Ability to prepare documentation for Administrative Court hearings.
Ability to work in a fast-paced time sensitive environment.
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
Valid Driver’s License.
Upon completion of training for Medicaid and Food Assistance worker must be able to pass the Colorado Benefit Management System (CBMS) test through the State SDC training system.

Nice To Haves

Spanish language proficiency.

Responsibilities

Determines initial and continuing eligibility for Health First Colorado (Medicaid), Food Assistance/SNAP, and Aid to the Needy Disabled (AND) Programs.
Processes applications and verifies information to approve or deny assistance based on program eligibility requirements.
Verifies information through direct contact, phone, email, and home visits.
Informs applicants/recipients of program requirements, benefits, and appeal rights.
Assists applicants in completing forms and securing necessary documents.
Informs recipients of changes in laws or regulations affecting their eligibility or grant amount.
Approves or denies applications and communicates decisions to applicants within the appropriate timeframe.
Enters accurate and complete data into the County Benefit Management System (CBMS).
Interprets computer-generated data for case processing (approvals, changes, denials, etc.).
Applies rules and regulations with prudent judgment, ensuring accuracy and verification of recipient information.
Determines the need for fund recovery or referral for fraud investigation.
Prepares and testifies at administrative hearings.
Provides information and assesses needs for referral to services staff and other community agencies.
Works scheduled hours as set by supervisor.
Follows policies and procedures of the County and State Department.
Works effectively in a team or independently as required.
Communicates effectively in English and Spanish (preferred).