Eligibility Specialist: Aid to Continue & Compliance

NYC Department of Social Services; New York (NY); On-site; USD 52,000 - 66,000; Full time

Job summary

NYC Department of Social Services is seeking an Eligibility Specialist, Level II, to serve as Aid to Continue Compliance Worker. The role involves reviewing Fair Hearing decisions, verifying eligibility using WMS/eMedNY/FHIS, and recalculating budgets to restore benefits as needed.

The position requires foundational education or experience in public assistance programs, strong interviewing and communication skills, and the ability to meet deadlines in a fast-paced environment.

Qualifications

• Completion of 30 semester credits at an accredited college or university; or a four-year high school diploma plus one year of related experience.
• Experience in interviewing, gathering information, and preparing documentation for eligibility decisions.
• Familiarity with Medicaid eligibility rules and Fair Hearing policies.

Responsibilities

• Review and analyze Fair Hearing decisions and directives to determine actions needed.
• Verify case information using WMS, eMedNY and FHIS to determine eligibility status and monitor deadlines.
• Recalculate budgets to restore benefits when required to reopen or adjust cases.
• Respond to inquiries from supervisors and provide case status updates; identify and correct errors.
• Provide information regarding PHD eligibility and ensure actions follow state regulations.

Skills

Medicaid eligibility

Interviewing skills

Communication

Time management

Organizational skills

Education

30 semester credits

High school diploma or equivalent with 1 year experience

Tools

WMS

eMedNY

FHIS

Word

Excel

Job description

NYC Department of Social Services is seeking an Eligibility Specialist, Level II, to serve as Aid to Continue Compliance Worker. The role involves reviewing Fair Hearing decisions, verifying eligibility using WMS/eMedNY/FHIS, and recalculating budgets to restore benefits as needed.

The position requires foundational education or experience in public assistance programs, strong interviewing and communication skills, and the ability to meet deadlines in a fast-paced environment.