SDS - Eligibility Specialist

Oregon Cascades West Council of Governments•Corvallis, OR

About The Position

The Eligibility Specialist performs specialized financial eligibility functions for publicly funded programs, including conducting interviews in person, by phone, or in the community; collecting and verifying financial information; making eligibility determinations; completing ongoing financial reviews; and using state and federal databases to collect and report data and issue benefits. The position is a mandatory reporter by statutory requirement. It is union represented and classified as FLSA non-exempt, making it eligible for overtime. A teleworking option may be available after probationary trial service. The role determines initial and ongoing eligibility for Medicaid programs, including the Oregon Health Plan and Medicare Savings Plans, SNAP, TANF, ERDC, and other programs. It works with case managers to establish financial eligibility for people applying for or receiving long-term support and services, and processes financial documentation within mandated timeframes. The specialist also provides customer service and benefits counseling, supports administrative processes, and helps applicants connect with additional services. The position receives general supervision from Senior and Disability Services Program Supervisor(s) and has no supervisory responsibilities. Work is primarily in an office using an agency-provided computer, telephone, and other office equipment. It involves prolonged sitting and extensive telephone and computer work, with occasional travel to meetings, training courses, or appointments with Oregonians.

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 knowledge, skills, and abilities to perform the job.
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 regarding client and provider records, including HIPAA regulations.
Knowledge of basic computer operations and experience with Microsoft software.
Ability to communicate effectively orally and in writing.
Ability to interview applicants effectively to determine program eligibility.
Ability to work effectively with applicants and use good judgment to troubleshoot case issues and errors.
Ability to interact with culturally diverse populations, representatives of other social agencies, and members of the public.
Ability to interact sensitively with older adults and/or persons with disabilities.
Ability to manage time, complete daily and ongoing tasks, work independently, and prioritize multiple tasks and 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 diffuse 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

Four-year college degree with major coursework in social services.

Responsibilities

Determine initial financial eligibility for Medicaid, SNAP, TANF, ERDC, and other programs.
Coordinate with case managers to establish financial eligibility for individuals applying for or receiving long-term support and services.
Collect, review, and process financial documentation and supporting data within rule-mandated timeframes.
Perform ongoing financial eligibility functions and routine renewals for Medicaid, SNAP, TANF, ERDC, and other programs.
Engage with Oregonians by phone, email, in the office, or in the community using person-centered, trauma-informed communication skills.
Counsel clients on basic Medicaid information, including Coordinated Care Organizations, income and resource standards, and other 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.
Participate in related hearings with the Hearing Officer.
Identify and refer applicants who may need additional support and services, including reporting allegations of abuse or neglect as a mandatory reporter.
Provide backup support as needed.
Attend unit meetings, staffing, and trainings as directed by the leadership team.
Maintain regular attendance and work cooperatively with agency staff, supervisors, and community partners to support customer service and effective team participation.