Eligibility Specialist I/II

County of Shasta•Redding, CA

4d•Hybrid

About The Position

Determines the eligibility of applicants and recipients for public assistance programs through interactive interviewing and fact gathering; maintains current knowledge of program regulations and procedures necessary for multi-program caseload administration; initiates and processes casework through an automated system; identifies needs and makes appropriate referrals for health, social, and/or employment services; and performs related work as required. The department encourages candidates to watch the following video about the Eligibility Specialist position: https://youtu.be/gOOTO9c3iOQ

Requirements

Knowledge of general goals and purpose of public social services programs
Knowledge of laws, rules, regulations, policies, and procedures governing eligibility for diverse public assistance programs and related case administrative techniques
Knowledge of methods and techniques of conducting an investigative interview and information gathering
Knowledge of computer terminology and automated computer systems
Knowledge of modern office practices, methods, and procedures
Knowledge of basic record keeping practices and procedures
Knowledge of principles of mathematical calculations
Knowledge of intricacies of health insurance plans, medical health plan options, and associated terminology
Knowledge of regulations and rules regarding household filing status related to the Affordable Care Act
Knowledge of cultural and human behavior, including knowledge of self, to interact effectively with clients and staff
Knowledge of principles and practices of effective customer service
Knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition and grammar
Knowledge of modern equipment and communication tools used for business functions and program, project, and task coordination
Knowledge of computers and software programs (e.g., Microsoft software applications) to conduct research, assess information, and/or prepare documentation
Ability to apply the policies, procedures, and programs of the Health and Human Services Agency
Ability to apply the laws, rules, and regulations governing eligibility and benefits determination for multiple public assistance programs and the case administration of these programs
Ability to identify available resources, and communicate with others to obtain and verify information concerning eligibility
Ability to use fact finding techniques and perform in-depth and interactive interviewing
Ability to determine appropriate course of action in emergency situations
Ability to make referrals to appropriate agencies and social service programs
Ability to detect and evaluate potential fraudulent situations
Ability to analyze and interpret written, numerical, and verbal data from various sources
Ability to utilize multiple electronic information and social services systems, and analyze and interpret such information
Ability to enter and maintain data accurately and timely into a computerized system
Ability to navigate through computer screens and effectively use computer systems, software applications, and modern business equipment to perform a variety of work tasks
Ability to identify when computer output is incorrect and make corrections
Ability to process cases manually as required
Ability to plan and organize caseload/tasks to ensure work is completed in accordance with regulations relating to eligibility and timeliness
Ability to function effectively in a system with strict deadlines and constant changes
Ability to read, understand, apply, and explain complicated and detailed correspondence and reports, regulations, and policy directives
Ability to perform a variety of mathematical computations accurately and rapidly
Ability to prepare clear, concise, and accurate records and reports
Ability to explain complex rules and programs so they can be understood by people of diverse socio-economic, cultural, and educational backgrounds
Ability to gather, record, and correctly evaluate tax filing data, income, and additional necessary information required for the determination of eligibility for one or more programs
Ability to explain health insurance plan options and plan details available to clients through the Affordable Care Act
Ability to review a variety of tax documents to obtain needed household filing information
Ability to explain health care reform tax credit implications to clients
Ability to refer clients to other agency and community services as needed
Ability to assess and manage difficult and hostile persons or situations, or call for intervention when appropriate
Ability to interact with people in a courteous manner in person, on the telephone, by mail, or email
Ability to work in a fast-paced, professional office environment and prioritize a wide range of duties with varying time requirements to ensure timely completion
Ability to communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax
Ability to establish and maintain cooperative working relationships with the public and staff
Ability to follow written and oral directions and instructions
Two (2) years of experience performing clerical duties; OR One (1) year of experience determining eligibility for loans, financial assistance, unemployment, or veterans’ benefits, or publicly or privately funded health, counseling, or social services; OR Completion of sixty (60) semester or ninety (90) quarter college units.

Nice To Haves

Possess a strong emphasis on continuous quality improvement
Strong work ethic and ability to prioritize assigned work tasks and follow through in a timely manner
Excellent listening and strong written and verbal communication skills
Excellent customer service skills and initiative
Solution based problem solving skills
Experience in maintaining cooperative relations and communications with customers, management, and staff
Ability to maintain a high standard of professionalism
Proficiency in MS Office suite as well as basic knowledge of software and database programs
One (1) year of full-time experience performing duties of the Eligibility Specialist I classification
Some positions may require possession of special language and culture skills as a bona fide qualification standard. In these cases, candidates must demonstrate that they possess the required skills.

Responsibilities

Performs interactive interviews in person or via the telephone to elicit eligibility information, obtain and/or verify financial, employment, tax, and personal demographic information, and determine eligibility for public assistance programs and services
Analyzes financial and eligibility information to determine initial or continuing eligibility for multiple public assistance programs
Explains regulations, rules, and policies to clients and apprises them of their rights, responsibilities, and eligibility for participation in various public assistance programs and services
Ensures accuracy and completion of application and declaration forms
Resolves discrepancies by securing documentation, medical records, and confirmation from other agencies
Initiates a total-household assistance case
Enters and retrieves numerical and narrative data, and issues benefits from automated computer systems
Determines the level of benefits to which the client is entitled by making complex computations and/or computer entries and then analyzes the results
Reviews and interprets information provided on a variety of forms both by the client and third parties to assist with eligibility determination
Evaluates clients for and answers questions on Advanced Payment Tax Credits related to health care reform
Explains a variety of plan options, costs, and individual plan features through Covered California
Monitors on-going eligibility by obtaining periodic updated information of eligibility factors and takes appropriate actions on changes
Determines the need for additional services and makes referrals as needed for employment and other services to outside agencies to assist clients toward self-sufficiency and directs clients accordingly
Organizes and prioritizes caseload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policy
Enters and maintains case records, including written narratives, forms, and computer documents in a clear and readable format
Troubleshoots task and/or case issues to determine appropriate resolution of problems, involving Help Desk as needed
Communicates both orally and in writing with clients and others related to the initial and ongoing eligibility determination while maintaining confidentiality
Responds to questions and complaints of clients in person, by telephone, mail, and/or email communication
Provides pertinent forms and pamphlets to clients as required
Identifies suspected fraud and makes referrals for investigation
Prepares correspondence and reports
Participates in special projects, studies, work assignments, and committees
Performs related duties as assigned