Eligibility Specialist

Job Descriptions : This position requires someone who can gather information AND likes working with numbers, policies and people to determine eligibility for social service programs.We look for individuals in our organization who are passionate about our mission and values, and providing excellent customer service.We value our employees, working closely with them to help them be successful. We value the people we provide services to, ensuring they receive the highest quality of customer service.Recruitment # : 257-12-24Closes : Open Until Filled (Last day for internal lateral transfer : 12 / 18 / 24)Location : McMinnville, ORSalary : Starting at $4,142 with excellent benefits. (See below)Agency Sponsored : Medical / Dental 100% paid for employee and 90-98% for dependents, generous Paid-time off, Public Employee Retirement (PERS), Employee Assistance Plan, Long Term Disability, great culture.Employee paid : Deferred Compensation, Life Insurance, Short Term Disability, Colonial Life Supplemental Plans, Legal Shield.General DescriptionMeets Agency Mission, Vision and Values by determining financial eligibility for benefits and enrolling consumers, and ongoing maintaining of consumer enrollment in various medical assistance programs.Essential FunctionsDetermine eligibility for participation in financial, medical, and SNAP benefitsConduct annual reviews of financial eligibility for participation in financial, medical and SNAP benefit programsProvides ongoing consumer maintenanceProvides additional assistance to consumers as neededPromotes person centered servicesProtects consumers and reduces Agency riskProvides excellent service in a professional mannerDetermine eligibility for participation in financial, medical and SNAP benefit programs by : Interview individuals via phone or in person to gather necessary information.Explain benefits and resources available.Review application document for completeness (may include helping individual through application process).Assist applicant in obtaining verifications.Collaborate and coordinate with others including Department of Human Services, Oregon Health Authority, Coordinated Care Organizations, attorneys, behavioral health partners, pharmacies, Social Security Administration, Medicare, medical providers, etc.Process forms and documents.Apply program rules and policy to determine if individual qualifies for programs.Provide notification of eligibility decisions timely and completely as outlined in rules and policy.Maintain electronic and paper consumer files.Cover incoming calls on eligibility for unit, i.e. “Worker of the Day.”Conduct annual reviews of financial eligibility for participation in financial, medical and SNAP benefit programsEnsure consumer receives re-determination information.Review returned materials for completeness.Contact consumer for additional information or to clarify as necessary.Apply program rules and policy to determine if individual continues to qualify for program.Provide notification of eligibility decisions timely and completely as outlined in rules and policy.Maintain electronic and paper consumer files.Process information, forms and documents between determinations to ensure consumer benefits are current.Provide ongoing consumer maintenanceReceive, review and process updated information from consumers.Adjust benefits as needed.Verify information.Provide additional assistance to consumers as neededProcess and review forms and data related to MMIS database.Provide addition resources and community referrals as appropriate.Attend consumer hearings and providing testimony as necessary.Process other reports as necessary, such as reporting deceased consumers, monthly reports to manager on closed, denied and withdrawn cases.(FOR BILINGUAL POSITIONS ONLY)Ensure Non-English speaking consumers receive servicesCommunicate with individuals whose primary language skills are non-English.Provide services to consumers whose primary language skills are non-English.Serve as an interpreter for the Agency in identified language pair, including oral and written, interpret and explain forms, explain rules and policies, etc.Translation of written materials.Promote person centered servicesEmbrace and exhibit the Agency Mission and Core Values.Understand the role of consumer choice.Interact with the public, consumers, co-workers and others in a patient, respectful and culturally appropriate manner.Educate self and others of resources available for populations served, including researching electronic and written materials and Aging and Disability Resource Connection of Oregon resource database.Understand other Agency resources and accessing resources and assistance to consumers as neededProtects consumers and reduces Agency riskFollow policies, regulations and requirements of project and Agency; document plan and progress as required.Serve as a Mandatory Reporter of suspected abuse of vulnerable populations as required by policy and regulation.Maintain and sharing information according to privacy regulations.Provides excellent service in a professional mannerMeet the needs of consumers, follow through, meeting deadlines, and maintain skills and knowledge to perform the job.Apply the required knowledge and skills and exhibit critical thinking and problem solving.Exhibit good decision making, problem solving and work habits.Meet quality standards in accuracy, judgment, timeliness and following policy and procedure.Exhibit good work habits, including organizational skills, regular attendance, working independently, seeking and offering assistance when needed.Exhibit technology skills related to the work needing to be done, (word processing, spreadsheets, database, internet research, mail, IM, phones, copiers, assessment programs like as CAPS, Oregon ACCESS, etc.);Regular attendance to meet the demands of this job and provide necessary services.Required Experience : Minimum Qualifications - Education and ExperienceA qualified applicant will have a minimum of four (4) years of equivalent combination of education and / or experience which demonstrates the knowledge, skills and abilities required to do the essential functions of this job. The following qualifications meeting the minimum requirements will be considered : Bachelor’s degree in social sciences or any related fieldWork or volunteer experience working directly with consumers in social service type settings. Experience can be substituted for education.Any combination of related education and relevant work experience equaling at least 4 years.(FOR BILINGUAL POSITIONS ONLY)Successful completion of a Language Proficiency TestKnowledge, Skills, and AbilitiesThe successful applicant must have the following general skills, including the ability to : Understand and interpret applicable policies and apply them to problem-solving and decision-making in order to serve external and internal customersApply the knowledge and skills in a timely, accurate, and efficient manner to meet deadlinesProcess a high volume of work with critical deadlinesOrganize and prioritize work to meet required time timeframesMulti-taskCollaborate and coordinate with othersBuild relationships and networkExhibit excellent interpersonal communication and listening skillsExhibit good judgment, and use courtesy and tactSpeak, read, write, and understand EnglishFollow verbal and written instructionKnow and commit to abide by rules governing consumer confidentiality and mandatory reportingThe successful applicant must have the following job-specificskills, including the ability to : Learn available services of Agency and other community servicesApply knowledge of program rulesUtilize general math skillsInterview and obtain general and financial informationUnderstand the role of the individual’s preferences in care successKeep up with fast changing rules through training and resources provided by the AgencyLearn and use database to maintain complete and timely files, including data entry and narration of ongoing workMeet quality work standardsLearn and apply general office practices such as confidentiality rules, employee records maintenance, client records maintenance, and agency policies and procedures applicable to the specific program and area of workUse extensive business-English skills (grammar, spelling, and punctuation)Operate a personal computer, copier, fax machine, phone, and general office equipment, etc.(For Bilingual) Successfully demonstrate the required level of oral and written proficiency for bilingual duties in identified language pair (English / Spanish, Russian, ASL, etc.)Other RequirementsThe successful applicant must have the following skills, including the ability to : Support the agency’s mission, ethics, and valuesSecure and maintain a valid driver’s license in the state of Oregon, or an acceptable alternative means of transportationCommit to regular attendance as it is required to meet the demands of this jobPass a criminal background check successfullyMaintain and share information according to privacy regulationsServe as a mandatory reporter of suspected abuse of vulnerable populations as required by policy and regulationComplete necessary work as assignedWORK ENVIRONMENT / PHYSICAL DEMANDSThis is a fast-paced, deadline-driven position where accuracy, efficiency and excellent customer services are essential. Frequent consumer contact, high volume detailed work.This job is performed primarily in the office with possible occasional work in the field.Office work will be conducted using general office equipment, includes substantial sitting and is performed primarily in a cubicle environment, with noise and interruptions, being on phones and working at a computer. Field work requires travel to clients in a variety of settings, homes, facilities, etc. of varying level of cleanliness and repair. Field work requires driving an Agency car or employee car, carrying and using a laptop computer.These essential outcomes require regular sitting, talking, hearing, computer use; frequently required to use repetitive hand motion, handle or feel, and to stand, walk, reach, bend or lift up to 25 pounds.Contact with the public in home or office environments may risk exposure to irrational / hostile behavior, contagious diseases, or contact with domestic animals.Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.Classification : Eligibility SpecialistBilingual Eligibility SpecialistPosition Number : 257Salary Range : R19FLSA Status : Non-ExemptUnit : VariesLocation : McMinnvilleReports to : Services ManagerUnion Status : RepresentedLast revision : May 2018This job description is a general guide for the job to be performed and does not cover everything. Employees may be required to perform other duties, including covering for, and in, other offices. Employees are expected to follow and perform other job-related duties requested by their manager.Reasonable accommodations will be made as needed.Job descriptions are subject to change.Keyword : detail, determine eligibility, social services, financial, customer service, interviewing, computer records, apply eligibility requirementsFrom : NorthWest Senior & Disability Services