Eligibility Specialist II – Long Term Care
About The Position
The Eligibility Specialist II determines initial and continued eligibility for public assistance programs in the Long-Term Care Eligibility Unit, with a strong focus on MaineCare policy. The position may also perform quality control reviews of eligibility decisions made by others. Work takes place in a fast-paced environment with high standards for customer service and program accuracy. The specialist gathers sensitive personal information to make timely and accurate eligibility determinations and interacts with people from varied backgrounds and in different emotional states, making interpersonal and conflict resolution skills important.
Requirements
- A four-year combination of education, training, and/or progressively responsible experience in a social services setting demonstrating interviewing and data-gathering skills needed to support judgments in eligibility determinations, claims resolutions, and/or customer service requests; OR a bachelor's degree in Social Services, Business Administration, or another related field.
- Strong interpersonal and conflict resolution skills.
Responsibilities
- Interview clients and obtain and assess facts, data, supporting information, and documentation for public assistance applications or recertifications.
- Evaluate information and apply allowable standards and criteria.
- Explain program eligibility requirements, rules, regulations, and individual rights and responsibilities to clients and their representatives.
- Review and analyze information for accuracy, identify inconsistencies, request documentation, and verify and validate data.
- Answer inquiries and refer clients to various programs.
- Enter data into an automated system accurately and ensure accurate eligibility results.
- Communicate verbally and in writing with clients, co-workers, and other agencies.
- Perform intermediate mathematical calculations.
- Maintain confidentiality of applicant and recipient information.
- Perform quality control reviews of eligibility decisions made by others, as needed.
Benefits
- 13 paid holidays and at least three weeks of annual vacation leave; vacation accrual increases with years of service.
- Personal leave for overtime-exempt employees.
- 12 days of sick leave per year.
- The State pays 85%–95% of employee-only health insurance premiums, depending on salary.
- A 5% health insurance premium credit is available for participation, subject to program requirements.
- The State pays 100% of employee-only dental insurance premiums.
- The State contributes an amount equivalent to 14.06% of employee pay to MainePERS.
- Gym membership reimbursement of up to $40 per month.
- Health and dependent care flexible spending accounts.
- Eligibility for Public Service Student Loan Forgiveness.
- Employee assistance program through the Living Resources Program.
- Six weeks of fully paid parental leave for employees welcoming a child, including non-birthing and adoptive parents.
- Additional unpaid leave may be available under the Family and Medical Leave Act.
- Voluntary pre-tax deferred compensation savings through a MaineSaves 457(b) account.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
