Eligibility Specialist II

About This Role

The Eligibility Specialist II determines eligibility for public assistance programs through interactive interviewing and fact gathering, maintaining current knowledge of program regulations and procedures. This role involves processing casework through automated systems, identifying needs, and making appropriate referrals for health, social, and/or employment services.

Responsibilities

• Perform interactive interviews to elicit eligibility information and determine eligibility for public assistance programs and services
• Analyze financial and eligibility information to determine initial or continuing eligibility for multiple aid programs
• Explain regulations, rules, and policies to clients and apprise them of their rights and responsibilities
• Resolve discrepancies by securing documentation, medical records, and confirmation from other agencies
• Enter and retrieve numerical and narrative data and issue benefits from an automated computer system
• Determine the level of benefits to which the client is entitled by making complex computations and/or computer entries
• Monitor ongoing eligibility by obtaining periodic updated information of eligibility factors and take appropriate actions on changes
• Determine need for additional services and make referrals as needed for employment and other services to outside agencies
• Organize and prioritize caseload to ensure necessary case records and documents are processed and updated within specific time limits
• Communicate both orally and in writing with clients and others related to eligibility determination while maintaining confidentiality

Requirements

• One year full-time experience as an Eligibility Specialist I in an IMS County OR two years full-time experience determining eligibility for public assistance programs in a public human services agency
• Knowledge of laws, rules, regulations, policies, and procedures governing eligibility for diverse public assistance programs
• Ability to conduct investigative interviews and gather information
• Proficiency with computer systems and software applications for data entry and retrieval
• Ability to perform mathematical calculations accurately and rapidly

Qualifications

• One (1) year full time experience in an Eligibility Specialist I classification in an Interagency Merit System (IMS) County; OR Two (2) years of full time experience determining eligibility for public assistance programs in a public human services agency.

Nice to Have

• Knowledge of intricacies of health insurance plans and medical health plan options
• Knowledge of regulations and rules regarding household filing status related to the Affordable Care Act
• Ability to assess and manage difficult and hostile persons or situations

Skills

* Required skills