Eligibility Specialist I

CalHR•Salinas or Seaside or King City, CA

2d•Onsite

About The Position

The Eligibility Specialist I is the entry-level classification in the Eligibility Specialist series. Incumbents may have prior experience determining eligibility for loans, financial assistance, unemployment or veterans benefits, or publicly or privately funded health, counseling or social services programs; have completed initial classroom training provided as part of the Eligibility Specialist Trainee training program; or may have the required level of education. Incumbents will be placed in a work team and initially may receive classroom instruction prior to being assigned casework and/or tasks. Incumbents will work under close supervision while learning to independently determine public assistance eligibility, and apply knowledge and skills learned from their training in completing eligibility tasks and applying complex regulations. As incumbents gain experience and work toward the journey level in the series, they are expected to work with more independence and have the ability to complete more complex tasks and/or handle larger client caseloads. Incumbents are expected to progress to the journey-level Eligibility Specialist II upon completion of one year of satisfactory performance in the entry-level Eligibility Specialist I classification.

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 computer keyboard arrangement
Knowledge of modern office practices, methods and procedures
Knowledge of 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 County Social Services Department
Ability to apply the laws, rules and regulations governing eligibility and grant 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, 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 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, 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 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
One year full-time experience in an Eligibility Specialist Trainee classification in an Interagency Merit System (IMS) county; OR
One (1) year of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits and two (2) years of clerical work involving public contact; OR
Two (2) years of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits ; OR
Four (4) years of full-time clerical work involving public contact, interviewing, math computations, completion of forms or eliciting information from the public; OR
Graduation from an accredited four-year college or university.
Qualifying experience or education may be combined in order to meet the above requirements.
When combining education and experience; fifteen (15) semester units or twenty-two and a half (22.5) quarter units equals six months of experience.

Nice To Haves

The ability to speak, read and write Spanish in addition to English would be an asset in this position but is not a requirement.

Responsibilities

Performs interactive interviews 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 aid 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
Enters and retrieves numerical and narrative data and issues benefits from an automated computer system
Determines the level of benefits to which the client is entitled by making complex computations and/or computer entries and then analyzing 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 (APTC) 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 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
Makes referrals to social service workers as needed
Participates in special projects, studies, work assignments and committees
Prepares correspondence and reports
Performs related duties as assigned