DSHS HCLA HCS Public Benefits Specialist 5

State of Washington•Multiple Locations Statewide, WA

3d•Hybrid

About The Position

Join our team as a Public Benefits Specialist 5 within DSHS’s Home and Community Living Administration (HCLA) in Washington State, where you will play a critical role in helping vulnerable adults access essential Long Term Services and Supports programs. In this position, you will independently determine and maintain financial eligibility for complex Medicaid and long-term care programs while interpreting and applying state and federal regulations. Your work directly supports individuals who rely on medical, financial, and community-based services to maintain their health, safety, and quality of life, making a meaningful impact on clients, families, and the communities we serve. Please note: This is a hybrid position. The candidate hired for this role will report to the Home and Community Services (HCS) office closest to their residence to provide in-office coverage as needed.

Requirements

One year of experience as a Public Benefits Specialist 3 or Public Benefits Specialist 4.
A bachelor’s degree and three years of experience in one or more of the following: Examining or processing medical insurance, rehabilitation, or unemployment insurance claims Providing staff support in public assistance eligibility determination Analyzing, verifying, and evaluating financial data and information.
Three years of out-of-state experience conducting financial eligibility determinations for public assistance programs, including financial, medical, and food benefits, may be considered qualifying experience.
Related or closely related professional experience may substitute year for year for education.
Employees driving on state business must have a valid driver's license.
Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.

Nice To Haves

Knowledge of Long Term Services and Supports programs, public assistance eligibility requirements, Medicaid policies, and applicable state and federal regulations.
Ability to interpret, analyze, and apply complex laws, policies, financial information, and eligibility requirements to make accurate independent decisions.
Strong communication and interpersonal skills with the ability to effectively work with clients, families, community partners, and multidisciplinary teams.
Ability to manage a high-volume caseload, prioritize competing responsibilities, and adapt to changing policies and program requirements in a fast-paced environment.
Experience using computerized systems and databases with the ability to quickly learn new technology and program-specific applications.
Strong interviewing, problem-solving, and conflict resolution skills with the ability to handle sensitive situations using professionalism, tact, and discretion.
Ability to prepare clear written correspondence, maintain accurate documentation, and provide equitable, client-centered services including accommodations and interpreter coordination when needed.

Responsibilities

Determine and maintain eligibility for Long Term Services and Supports programs, including Medicaid-funded and state-funded services, in accordance with Washington Administrative Code and agency policies.
Conduct comprehensive interviews by phone, video, and in person to gather and verify financial, medical, and program eligibility information.
Analyze complex financial, legal, and medical documentation including trusts, annuities, property records, insurance policies, and income/resources to determine eligibility.
Manage ongoing caseloads by processing changes, maintaining accurate records, issuing timely notifications, and ensuring continued program compliance.
Coordinate services and collaborate with Social Service Specialists, Area Agency on Aging Case Managers, medical providers, guardians, attorneys, and community partners to support client care and placement needs.
Respond to emergent situations such as hospital discharges, facility closures, and expedited benefit requests to ensure timely access to services.
Provide guidance and technical assistance regarding Long Term Services and Supports programs, policies, procedures, and community resources to clients, families, providers, and internal staff.
Utilize multiple automated systems to process eligibility actions, maintain data integrity, and ensure confidentiality of client information.
Identify client support needs, make appropriate referrals, address complaints or discrepancies, and coordinate accommodations and interpreter services to ensure equitable access to programs and services.