Eligibility Specialist III

CalHR; California; On-site; USD 50,000 - 70,000; Full time

Job summary

A public assistance organization in California seeks an experienced Eligibility Specialist III to lead a unit determining eligibility for assistance programs. This role involves complex assessments, training staff, and maintaining accurate case records. Candidates should have relevant eligibility determination experience and possess strong analytical and communication skills. This position offers an opportunity to make a meaningful impact in public service.

Qualifications

• Experience in an Eligibility Specialist II classification in an Interagency Merit System County.
• Three years of experience determining eligibility for public assistance programs.
• Valid driver's license required.

Responsibilities

• Provides lead direction and training to a unit of workers.
• Performs interactive interviews to determine eligibility.
• Analyzes financial information for aid program eligibility.
• Explains regulations and assists with applications.
• Resolves discrepancies and enters data in automated systems.

Skills

Analyzing financial information

Interviewing skills

Mathematical computations

Communication (oral and written)

Organizational skills

Job description

The Eligibility Specialist III is the advanced journey/lead-level classification and subject matter expert in the Eligibility Specialist series. Incumbents perform the most complex work and specialized assignments requiring an advanced level of technical knowledge in public assistance programs, departmental processes and caseload/workload administration.

Incumbents are expected to independently perform specialized and/or complex duties beyond the journey-level classification of the series. In addition, incumbents may perform help desk functions, provide training to a unit of workers determining eligibility for public assistance and/or serve as a lead worker for less experienced employees.

Responsibilities include:

• Provides lead direction and/or training to a unit of workers determining eligibility of applicants and recipients for public assistance programs
• Provides support to supervisor with unit operations and coverage
• Performs interactive interviews to elicit eligibility information, obtain and/or verify financial, employment, tax and personal demographic information and identify need for public assistance programs and services
• Assists in the development and implementation of procedures for public assistance programs
• Analyzes financial and eligibility information to determine initial or continuing eligibility for multiple aid programs
• May provide services to drop-in clients, perform local help desk functions, provide lead direction and training to unit staff and assist with the more complicated cases, or perform specialized assignments in the areas of investigations, quality assurance and control and fair hearings
• Explains regulations, rules and policies to clients and apprises them of their rights, responsibilities and eligibility for participation
• 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 mathematical computations and/or complex computer entries
• 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/workload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policy
• Completes 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; may participate in system testing and design
• 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, meetings, conferences and committees
• Prepares correspondence and reports
• Performs related duties as assigned

Requirements:

• One (1) year full time experience in an Eligibility Specialist II classification in an Interagency Merit System (IMS) County
• OR
• Three (3) years of full time experience determining eligibility for public assistance programs in a public human services agency

A valid driver's license will be required at the time of interview. Individuals who do not meet this requirement due to a disability will be reviewed on a case-by-case basis.

Positions require pre-employment screening, including background checks, and fingerprinting.

Lake County is an equal opportunity employer and values diversity in the workplace.