Eligibility Specialist I

Overview

Position Information

SALARY RANGE
Eligibility Specialist I: $2,794.00 – $3,567.00 per month

Examples of Duties

• Performs interactive interviews to elicit eligibility information, obtain and/or verify financial, employment, tax and personal demographic information and determine eligibility for public assistance programs and services
• Analyzes financial and eligibility information to determine initial or continuing eligibility for multiple aid programs
• Explains regulations, rules and policies to clients and apprises them of their rights, responsibilities and eligibility for participation in various public assistance programs and services
• Ensures accuracy and completion of application and declaration forms
• Resolves discrepancies by securing documentation, medical records and confirmation from other agencies
• Enters and retrieves numerical and narrative data and issues benefits from an automated computer system
• Determines the level of benefits to which the client is entitled by making complex computations and/or computer entries and then analyzing the results
• Reviews and interprets information provided on a variety of forms both by the client and third parties to assist with eligibility determination
• Evaluates clients for and answers questions on Advanced Payment Tax Credits (APTC) related to health care reform
• Explains a variety of plan options, costs and individual plan features through Covered California
• Monitors on-going eligibility by obtaining periodic updated information of eligibility factors and takes appropriate actions on changes
• Determines need for additional services and makes referrals as needed for employment and other services to outside agencies to assist clients toward self-sufficiency and directs clients accordingly
• Organizes and prioritizes caseload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policy
• Enters and maintains case records, including written narratives, forms and computer documents in a clear and readable format
• Troubleshoots task and/or case issues to determine appropriate resolution of problems, involving Help Desk as needed
• Communicates both orally and in writing with clients and others related to the initial and ongoing eligibility determination while maintaining confidentiality
• Responds to questions and complaints of clients in person, by telephone, mail and/or email communication
• Provides pertinent forms and pamphlets to clients as required
• Identifies suspected fraud and makes referrals for investigation
• Makes referrals to social service workers as needed
• Participates in special projects, studies, work assignments and committees
• Prepares correspondence and reports
• Performs related duties as assigned

• General goals and purpose of public social services programs
• Laws, rules, regulations, policies and procedures governing eligibility for diverse public assistance programs and related case administrative techniques
• Methods and techniques of conducting an investigative interview and information gathering
• Computer terminology and computer keyboard arrangement
• Modern office practices, methods and procedures
• Record keeping practices and procedures
• Principles of mathematical calculations
• Intricacies of health insurance plans, medical health plan options and associated terminology
• Regulations and rules regarding household filing status related to the Affordable Care Act
• Cultural and human behavior, including knowledge of self, to interact effectively with clients and staff
• Principles and practices of effective customer service
• Structure and content of the English language including the meaning and spelling of words, rules of composition and grammar
• Modern equipment and communication tools used for business functions and program, project and task coordination
• Computers and software programs (e.g., Microsoft software applications) to conduct research, assess information and/or prepare documentation

• Apply the policies, procedures and programs of the County Social Services Department
• Apply the laws, rules and regulations governing eligibility and grant determination for multiple public assistance programs and the case administration of these programs
• Identify available resources and communicate with others to obtain and verify information concerning eligibility
• Use fact finding techniques and perform in-depth and interactive interviewing
• Determine appropriate course of action in emergency situations
• Make referrals to appropriate agencies and social service programs
• Detect and evaluate potential fraudulent situations
• Analyze and interpret written, numerical and verbal data from various sources
• Utilize multiple electronic information social services systems and analyze and interpret such information
• Enter and maintain data accurately and timely into a computerized system
• Navigate through computer screens and effectively use computer systems, software applications and modern business equipment to perform a variety of work tasks
• Identify when computer output is incorrect and make corrections
• Process cases manually as required
• Plan and organize caseload to ensure work is completed in accordance with regulations relating to eligibility and timeliness
• Function effectively in a system with strict deadlines and constant changes
• Read, understand, apply and explain complicated and detailed correspondence, reports, regulations and policy directives
• Perform a variety of mathematical computations accurately and rapidly
• Prepare clear, concise and accurate records and reports
• Explain complex rules and programs so they can be understood by people of diverse socio-economic, cultural and educational backgrounds
• Gather, record and correctly evaluate tax filing data, income and additional necessary information required for the determination of eligibility for one or more programs
• Explain health insurance plan options and plan details available to clients through the Affordable Care Act
• Review a variety of tax documents to obtain needed household filing information
• Explain health care reform tax credit implications to clients
• Refer clients to other community services as needed
• Assess and manage difficult and hostile persons or situations; or call for intervention when appropriate
• Interact with people, in a courteous manner in person, on the telephone, by mail or email
• Work in a fast-paced, professional office environment and prioritize a wide range of duties with varying time requirements to ensure timely completion
• Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax
• Establish and maintain cooperative working relationships with the public and staff
• Follow written and oral directions and instructions

Minimum Qualifications

ELIGIBILITY SPECIALIST I

Pattern 1: One (1) year full-time experience in an Eligibility Specialist Trainee classification in an Interagency Merit System (IMS) county;

OR

Pattern 2: One (1) year of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits AND two (2) years of clerical work involving public contact;

OR

Pattern 3: Two (2) years of full-time experience determining eligibility for health programs, loans, financial assistance, unemployment, or other benefits;

OR

Pattern 4: Four (4) years of full-time clerical work involving public contact, interviewing, math computations, completion of forms or eliciting information from the public;

OR

Pattern 5: Graduation from an accredited four-year college or university.

Qualifying experience or education may be combined in order to meet the above requirements. When combining education and experience; fifteen (15) semester units or twenty-two and a half (22.5) quarter units equals six months of experience.

ADDITIONAL INFORMATION 

Minimum Education and Experience