Eligibility Specialist II

Department of Health and Human Services • Augusta, GA

1d • Hybrid

About The Position

The Department of Health and Human Services (DHHS) is seeking an Eligibility Specialist II for the Long-Term Care Eligibility Unit. This position focuses on MaineCare policy and involves determining initial and continued eligibility for public assistance programs. The role may also include quality control by reviewing eligibility decisions made by others. It operates in a fast-paced environment with high standards for customer service and program accuracy. The Eligibility Specialist II gathers sensitive personal information to make timely and accurate eligibility determinations and requires strong interpersonal and conflict resolution skills due to interactions with diverse individuals in various emotional states.

Requirements

• A four (4) year combination of education, training, and/or progressively responsible experience in a social services setting which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and/or customer service requests
• A Bachelors Degree in Social Services, Business Administration, or other related field.

Responsibilities

• Determines initial and continued eligibility for public assistance programs.
• Focuses on MaineCare policy.
• May perform quality control work by reviewing eligibility decisions made by others.
• Gathers sensitive and personal information to make timely and accurate eligibility determinations.
• Interviews clients, obtains and assesses all necessary facts, data, supporting information, and documentation pertaining to the application or recertification for public assistance.
• Evaluates information and applies allowable standards and criteria.
• Explains program eligibility requirements, rules, regulations and individual rights and responsibilities to clients and their representatives.
• Reviews and analyzes information for accuracy; identifies inconsistencies; requests necessary documentation; verifies and validates data.
• Answers inquiries and refers clients to various programs.
• Accurately enters data into an automated system and ensures accurate eligibility results.
• Communicates verbally and in writing with clients, co-workers and other agencies.
• Performs intermediate mathematical calculations.
• Maintains confidentiality of all applicant and recipient information.

Benefits

• 13 paid holidays
• 12 days of sick leave
• 3+ weeks of vacation leave annually
• Health Insurance Coverage (State pays 85%-100% of employee-only premiums)
• Health Insurance Premium Credit (decreases employee-only premiums by 5%)
• Dental Insurance (State pays 100% of employee-only dental premiums)
• Retirement Plan (State contributes 14.11% of employee's pay towards MainePERS)
• Six weeks of fully paid parental leave for all employees welcoming a child
• Additional, unpaid leave may also be available, under the Family and Medical Leave Act

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level