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Eligibility Worker performs intermediate administrative and technical work evaluating and explaining program benefit and eligibility requirements to applicants and clients, processing applications and recertification, according to county, state and federal policies, statutes and guidelines, and related work as apparent or assigned. Work is performed under the limited supervision of the Income and Health Care Assistance Supervisor.
- Interviews clients; obtains and verifies information necessary to process applications and recertification.
- Enters case specific information for applications, recertification and unscheduled reported changes into state and local databases and computer systems.
- Educate clientele on rights and responsibilities, appeals, program policies and guidelines, reporting requirements and privacy practices.
- Maintain comprehensive knowledge and understanding of policies and procedures governing the administration of public assistance programs.
- Respond timely to client questions or concerns.
- Maintains case files and records maintenance, determines eligibility which includes: approving, modifying, denying or terminating program eligibility in accordance with state polices, procedures and timelines
Special Requirements
- Associates/technical degree with coursework in paralegal, business, public administration behavioral or social sciences or related field considerable (3-5 years) experience working with at-risk populations and the public - - OR - - High school diploma/GED and a minimum of 3 years of experience working County Human Services.
- Valid driver's license
- Ability to pass a background check
- One year experience of MAXIS Health Care preferred
Qualification RequirementsTo perform this job, individuals must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Functions
- Conducts client interviews to determine need and eligibility for public assistance programs.
- Inputs information obtained from applications, recertifications and reported changes into state and local databases and computer systems to approve, modify, deny or terminate program eligibility in accordance with state policies, procedures and timelines.
- Maintains complete and accurate client records for administered programs.
- Collaborates with internal and external agencies, partners, and providers to establish and maintain client services.
- Calculates recovery and over paid benefit amounts to recapture revenue for county, state and federal government agencies.
- Identifies when fraud is suspected or reported and initiate referral to Fraud Prevention Investigator when necessary.
- Demonstrates continued knowledge of State Database systems and programs, utilizing all forms of training.
- Participates in on-going educational and developmental courses to enhance service delivery.
- Educates clientele on rights and responsibilities, appeals, program policies and guidelines, reporting requirements and privacy practices.
- Maintains comprehensive knowledge and understanding of policies and procedures governing the administration of public assistance programs.
- Mentors and provides on-going support and training to peers.
- Responds timely to client questions or concerns.
- Coordinate with internal and external community agencies, partners, and providers to address client financial needs. Provide potential benefit information and community resources to clients.
- Performs related work as assigned.