SDS - Eligibility Specialist

Human Resources•Toledo, OR

5d•$26 - $36

About The Position

The Eligibility Specialist performs specialized financial eligibility functions, including conducting interviews in person, by phone, or in the community; collecting and verifying financial information; determining eligibility; completing ongoing financial reviews; and using state and federal databases to collect and report data and issue benefits. The role determines eligibility for Medicaid, SNAP, TANF, ERDC, and other programs, including coordinating with case managers on eligibility for individuals applying for or receiving long-term support and services. The position is a mandatory reporter by statutory requirement and is union represented, FLSA non-exempt, and eligible for overtime. The role serves Oregonians by phone, email, in person, or in the community, using person-centered and trauma-informed communication. It provides basic counseling on Medicaid and Medicare-related benefits and supports enrollment in Medicare Advantage and prescription plans. Other duties include referring overpayments, assisting with voter registration, preparing for and participating in case audits and hearings, identifying applicants who may need additional support, and providing backup support as needed. The employee is expected to promote respectful and compassionate customer service, effective teamwork, productive working relationships with agency staff and community partners, critical thinking, and a positive and inclusive work atmosphere. Regular attendance is required. Work is primarily in an office and involves extended sitting, telephone work, and computer work. Occasional travel to meetings, training, or appointments with Oregonians is required. A teleworking option may be available after the probationary trial service period.

Requirements

Graduation from a four-year college or university with major coursework in social services is preferred, and/or a satisfactory equivalent combination of education, training, and experience demonstrating the ability to perform the job duties.
Knowledge of the functions and scope of public and private agencies and institutions providing social support services to vulnerable populations.
Knowledge of problems and issues confronting low-income households in the local community.
Knowledge of confidentiality rules for client and provider records, including HIPAA regulations.
Basic computer-operation skills and knowledge of and experience with Microsoft software.
Ability to communicate effectively orally and in writing.
Ability to interview applicants effectively to determine program eligibility.
Ability to use good judgment to troubleshoot case issues and errors.
Ability to interact with culturally diverse populations, representatives of social agencies, and members of the public.
Ability to interact sensitively with older adults and/or people with disabilities.
Ability to manage time, complete daily and ongoing tasks, work independently, prioritize multiple tasks, and handle a high volume of work.
Ability to compute and process required documents and recognize mathematical errors.
Ability to research, interpret, and implement Oregon Administrative Rules, Social Security rules, and other state and federal rules, regulations, and policies.
Ability to assess and defuse emotionally charged situations in person or over the telephone.
Valid Oregon driver's license or ability to obtain reliable transportation for assigned travel.
Successful completion of a criminal history and driving record check.

Nice To Haves

Bilingual English/Spanish skills are encouraged.
A four-year college degree with major coursework in social services is preferred.

Responsibilities

Determine initial and ongoing financial eligibility for Medicaid, SNAP, TANF, ERDC, and other programs.
Coordinate with case managers to establish financial eligibility for people applying for or receiving long-term support and services.
Collect, review, and process financial documentation and supporting information within rule-mandated timeframes.
Conduct interviews and financial reviews in person, by phone, or in the community.
Use state and federal database systems to collect and report data and issue benefits.
Engage with Oregonians by phone, email, in person, or in the community using person-centered, trauma-informed communication.
Counsel clients on basic Medicaid information, including coordinated care organizations, income and resource standards, and eligibility factors.
Counsel Oregonians regarding the Medicare Modernization Act and facilitate enrollment in Medicare Advantage and Medicare Prescription Plans.
Refer overpayments to Overpayment Writers.
Assist clients with voter registration.
Prepare for and participate in case audits and related hearings with the Hearing Officer.
Identify and refer applicants who may need additional support and services, and report allegations of abuse or neglect as a mandatory reporter.
Provide backup support, attend meetings and trainings as directed, and contribute to effective team participation and collaborative working relationships.