Eligibility Worker

Renville County•Olivia, MN

3d•$50,024 - $67,954•Onsite

About The Position

This position involves administering Eligibility Determination for Federal and State Public Assistance. The role requires conducting complex case evaluations and interviews with clients to assess eligibility for financial assistance programs in accordance with federal, state, and local laws, policies, and procedures. Responsibilities include ongoing case management, maintaining accurate client records, communicating client changes, informing clients of eligibility status, referring them to programs and community resources, and guiding them toward self-support. The role also involves composing correspondence, constructing reports, resolving various system matches, authorizing and educating clients on healthcare access plans, assisting with health plan problems, and imposing sanctions for non-compliance. Additionally, the position requires determining cost-effective insurance, analyzing health insurance policies, determining eligibility for Medicare premium reimbursement, and authorizing payments. The Eligibility Worker will also prepare for and participate in Appeal Hearings, including preparing testimony, case documentation, and financial calculations. Identifying potential fraud, providing data to law enforcement and the County Attorney's Office, and preparing cases for administrative disqualification or prosecution are also key duties. Recreating budgets to determine overpayments and authorizing recoupment of funds are part of the role. Administrative duties include explaining financial programs to agency staff and the public, representing the agency, researching and interpreting policies and regulations, and participating in professional development to stay current with changes in financial assistance programs. Providing excellent customer service is essential, along with other assigned duties.

Requirements

Two years of study from an accredited two- or four-year college with emphasis in behavioral science, business or closely related subjects; or two years of clerical experience in a social services/human services agency; or three years of clerical experience and/or experience working with the public; or a Technical College Human Services Eligibility Worker Diploma; or equivalent combination of education and experience.
Ability to read, analyze and interpret diversified, complex data, legal documents, IRS forms, insurance information, technical procedures, government regulations, etc.
Ability to write reports, business correspondence and policy/procedure manuals.
Ability to effectively interview clients, present information and respond to questions from groups of managers, customers and the public.
Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages.
Ability to use state and county computer systems (e.g. Microsoft Office, MAXIS, MMIS, METS, PRISM, ISDS, SIR, EDMS, AVS, SMI, DEED, WF1 and Bluezone Scripts).
Ability to use/operate office equipment such as computer, telephone, fax machine, copier, printer, scanner, and miscellaneous department tools and equipment.
Considerable ability to solve complex problems and deal with varied situations where only limited standardization exists.
Ability to interpret a variety of complex policy and procedures furnished in written, oral, diagram, or schedule form.
To remain objective and non-judgmental and to complete work accurately and timely in accordance with state and federal regulations.
Ability to handle confidential information and follow data practices requirements.
Ability to thrive in ambiguous, fast paced, demanding, and constantly changing work environment while maintaining strong critical thinking, communication and organization skills.
Employee is responsible and accountable for daily determinations of eligibility and benefit/grant decisions.
The ability to correctly assess and utilize federal, state, and local dollars to prevent lost revenues and federal sanctions.
Positions in this job typically require sitting, walking, standing, driving, talking, hearing, typing, repetitive movement, and seeing.
There is exposure to computer keyboards and computer screens.
The employee must occasionally lift and /or move up to 20 pounds.
Specific vision abilities required by this job include close vision, distance vision, and color vision.
There is exposure to hostile, despondent, uncooperative persons, and persons with numerous needs, which may result in exposure to offensive language and mental stress and effort.
The ability to assess and diffuse these situations is essential.

Nice To Haves

Multilingual skills are beneficial.

Responsibilities

Administer Eligibility Determination for Federal and State Public Assistance.
Conducts complex case evaluations and extensive personal interviews with clients for purpose of assessing eligibility.
Determines eligibility, and recertification, of benefits for financial assistance programs in accordance to federal, state and local laws, policies and procedures.
Provide ongoing case management.
Maintains complete and accurate records on client’s eligibility for all assigned programs to meet state and federal requirements of Department of Human Services Quality Control and Program Compliance Audits.
Communicates client changes that are considered vital to appropriate staff.
Informs clients of eligibility status, refers to programs and other community resources, guide to self-support.
Composes correspondence and constructs reports.
Resolve Income Eligibility Verification System, PARIS, and New Hire Matches timely. Adjust Benefit amount or close the case.
Authorize, educate, and enforce the county healthcare access plan.
Assists clients in resolving health plan problems, investigating issues and providing resolution.
Impose sanctions or disqualification for clients out of compliance.
Determine Cost Effective Insurance by analyzing Health Insurance policies.
Determine eligibility for monthly Medicare premium reimbursement.
Authorize payments to reimburse the client.
Prepare and participate in Appeal Hearings and complete case action as needed.
Prepares testimony, case documentation, financial calculation and exhibits for hearings.
Review complex situations with county attorney.
Testify to appeals judge on policy and procedures.
Identify potential fraud, provide data and information to Law Enforcement and County Attorney’s Office, and prepare cases for administrative disqualification or prosecution.
Recreate budget to determine overpayments and authorize recoupment of funds.
Clarify and explain information on financial programs to other agency staff, County Board, clients, potential clients, attorneys, authorized representatives.
Represent agency at request of agency Director or County Board.
Research and interpret policies and regulations established by legislative statutes and MN Department of Human Services Rules for the purpose of determining eligibility programs.
Participate in professional staff development, training sessions and meetings to remain current regarding legislative, policy, and procedure changes in financial assistance program requirements.
Provide excellent customer service.
Other duties as assigned.