Eligibility Specialist I/II

County of Shasta•Redding, CA

2d•Onsite

About The Position

This position is within the Shasta County Health and Human Services Agency (HHSA) Economic Mobility Branch. The branch provides assistance and services to individuals and families in the community, including initial and ongoing eligibility determination for public benefits such as CalFresh, CalWORKs, General Assistance, Healthcare Programs, and WIC. The branch also offers employment preparation and support services, behavioral health, and comprehensive perinatal alcohol and drug counseling. Recently, a new division was added to consolidate and streamline homeless and housing services. The Economic Mobility Branch also provides referrals to other services within the HHSA and the community. The Eligibility Specialist role involves determining the eligibility of applicants and recipients for public assistance programs through interactive interviewing and fact-gathering, maintaining current knowledge of program regulations and procedures, processing casework through an automated system, and identifying needs for referrals to health, social, and/or employment services.

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.
One (1) year of full-time experience performing duties of the Eligibility Specialist I classification.

Nice To Haves

Possession of special language and culture skills as a bona fide qualification standard may be required for some positions.

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.