Eligibility Specialist II (MSS)

CalHR•Crescent City, CA

10d

About The Position

The Eligibility Specialist II is the journey-level classification in the Eligibility Specialist series. The position determines applicants’ and recipients’ eligibility for public assistance programs through interactive interviewing and fact gathering, maintains current knowledge of program regulations and procedures for multi-program caseload administration, initiates and processes casework through automated systems, identifies needs and makes appropriate referrals, and performs related work. Incumbents demonstrate working knowledge of eligibility regulations, procedures, and software systems, and independently handle more complex tasks and caseloads, consulting Eligibility Specialist IIIs or Eligibility Supervisors as needed. Positions are flexibly staffed and are normally filled through advancement from the lower level. Outside applicants must have prior experience as an Eligibility Specialist, Eligibility Worker, or in a comparable position. Eligibility Specialist II incumbents typically receive supervision from an Eligibility Supervisor and may receive lead direction from an Eligibility Specialist III. The recruitment may be used to fill full-time, part-time, and extra-help positions as vacancies occur.

Requirements

One year of full-time experience as an Eligibility Specialist I in an Interagency Merit System (IMS) County; or two years of full-time experience determining eligibility for public assistance programs in a public human services agency.
Knowledge of public social services programs; eligibility laws, rules, regulations, policies, procedures, and case administration; investigative interviewing and information gathering; recordkeeping; mathematical calculations; health insurance plans and terminology; Affordable Care Act household filing rules; customer service; English language usage; office equipment; and computers and software applications.
Ability to apply county social services policies and eligibility rules; gather and verify information; conduct in-depth interviews; analyze and interpret data and electronic records; identify appropriate actions and referrals; detect potential fraud; and enter accurate, timely information into computerized systems.
Ability to organize caseloads and meet strict deadlines amid frequent changes; process cases manually when required; perform mathematical computations; prepare accurate records and reports; and explain complex programs and health plan options to people from diverse backgrounds.
Ability to manage difficult or hostile situations, communicate clearly and courteously, follow directions, and maintain cooperative working relationships with clients, the public, and staff.
Essential personal qualifications include integrity, initiative, dependability, good judgment, the ability to work cooperatively, and health consistent with performing assigned duties.
A valid driver's license may be required at appointment; employees may also be required to drive their own car, provide proof of insurance, and obtain DMV clearance.
Proof of ability to work in the United States is required as a condition of employment.

Responsibilities

Conduct interactive interviews to obtain or verify financial, employment, tax, and personal demographic information and determine eligibility for public assistance programs and services.
Analyze financial and eligibility information to determine initial or continuing eligibility for multiple aid programs.
Explain program regulations, rules, policies, client rights, responsibilities, and eligibility.
Ensure application and declaration forms are accurate and complete.
Resolve discrepancies by obtaining documentation, medical records, and confirmation from other agencies.
Enter and retrieve data and issue benefits through automated computer systems.
Calculate benefit levels and analyze computer results.
Review and interpret information on forms completed by clients and third parties.
Evaluate clients for and answer questions about Advanced Payment Tax Credits (APTC) and explain Covered California plans, costs, and features.
Monitor ongoing eligibility, obtain updated information, and take appropriate action when eligibility factors change.
Identify service needs and refer clients to employment, social service, and other community agencies.
Organize and prioritize caseloads and process and update records within regulatory and local-policy time limits.
Maintain clear, readable case records, narratives, forms, and computer documents.
Troubleshoot task and case issues and involve the Help Desk as needed.
Communicate with clients and others about eligibility determinations while maintaining confidentiality.
Respond to client questions and complaints in person, by telephone, mail, or email, and provide required forms and pamphlets.
Identify suspected fraud and refer cases for investigation.
Participate in special projects, studies, work assignments, and committees.
Prepare correspondence and reports and perform related duties as assigned.