Eligibility Specialist II — Case Review & Training

Florida; Florida; On-site; USD 33,000 - 41,000; Full time

Job summary

The Florida Department of Children & Families – Office of Economic Self-Sufficiency in Riviera Beach, FL, is seeking an Eligibility Specialist II. This Career Service role performs case reviews, maintains eligibility determinations, and provides training to staff to improve accuracy and timeliness.

Annual salary is $37,035.96, with state policy guiding compensation. The position requires prioritizing workload in a deadline-driven environment and adherence to federal and state rules on public

Qualifications

• Performs quality management system reviews as assigned.
• Reviews case reading errors with the Eligibility Self Sufficiency Specialist I, and ensures corrections are completed accurately and timely.
• Reviews and analyzes data from quality control and all monitoring sources and provides training in the areas in which problems are identified.
• Follows established unit procedures to determine eligibility for public assistance benefits within designated time frames as required by Federal and State laws and Department policy and procedures.
• Maintains assigned work responsibilities by taking prompt action on all case management activities including medical expense (bill) tracking, changes, sanctions, data exchange, alerts, ad-hoc reports, and Medicaid file resolution.
• Identifies cases of possible fraud and/or overpayment; makes appropriate referrals to fraud and overpayment departments.
• Ensures electronic case records are documented thoroughly and properly as required by Departmental procedures.

Responsibilities

• Performs quality management system reviews as assigned.
• Reviews case reading errors with the Eligibility Self Sufficiency Specialist I, and ensures corrections are completed accurately and timely.
• Reviews and analyzes data from quality control and all monitoring sources and provides training in the areas in which problems are identified.
• Follows established unit procedures to determine eligibility for public assistance benefits within designated time frames as required by Federal and State laws and Department policy and procedures.
• Maintains assigned work responsibilities by taking prompt action on all case management activities including medical expense (bill) tracking, changes, sanctions, data exchange, alerts, ad-hoc reports, and Medicaid file resolution.
• Identifies cases of possible fraud and/or overpayment; makes appropriate referrals to fraud and overpayment departments.
• Ensures electronic case records are documented thoroughly and properly as required by Departmental procedures.

Job description

The Florida Department of Children & Families – Office of Economic Self-Sufficiency in Riviera Beach, FL, is seeking an Eligibility Specialist II. This Career Service role performs case reviews, maintains eligibility determinations, and provides training to staff to improve accuracy and timeliness.

Annual salary is $37,035.96, with state policy guiding compensation. The position requires prioritizing workload in a deadline-driven environment and adherence to federal and state rules on public