Caseworker, G12, Public Health Services

Job Summary

This position is responsible for participating in the review of client applications to determine program eligibility. An incumbent in this position may be designated “Senior Caseworker”.

Major Duties

• Reviews client cases to determine program eligibility; reviews applications for accuracy and completeness; gathers and makes copies of required documentation.
• Interviews applicants and program recipients regarding their medical necessities.
• Determines household composition; verifies residency, resources, and income.
• Prepares required reports and obtains client signatures.
• Reviews eligibility criteria to make eligibility determinations.
• Updates, maintains and verifies case record information.
• Reviews cost estimates, CPT codes and physician orders to make necessary calculations.
• Schedules client appointments.
• Reviews and prepares medical claims for payment for clients, including qualifying jail inmates.
• Posts checks received for processed claims; enters check information to the request log.
• Prepares explanations of benefits for providers for all paid claims.
• Resolves client and provider billing questions and concerns.
• Performs outreach efforts.
• Maintains related client files and records; maintains log reports.
• Maintains contact with state and local agencies to follow-up on the status of client benefits.
• Reviews and assesses active cases as required.
• Processes and evaluates burial/cremation assistance applications.
• Processes and evaluates emergency medication assistance and pharmaceutical assistance program applications.
• Performs any other duties as assigned.

• Knowledge of relevant federal and state laws, county ordinances, and department policies and procedures.
• Knowledge of the Texas Health and Safety Code and the Indigent Health Care Program Handbook.
• Knowledge of community social welfare programs and resources.
• Knowledge of computers and job-related software programs.
• Skill in problem solving.
• Skill in prioritizing and planning.
• Skill in interpersonal relations.
• Skill in oral and written communication.
• Ability to communicate orally and in writing in the English language and orally in the Spanish language.

Minimum Qualifications

• Must have a high school diploma or GED from an accredited institution.
• Must have at least one ( 1 ) year of related experience.
• Must be able to type 35 wpm.

Supplemental Information

Complexity/Scope of Work

• The work consists of related duties in the determination of applicant eligibility for program services. Strict regulations contribute to the complexity of the position.
• The purpose of this position is to participate in the evaluation and processing of client applications and claims. Successful performance helps ensure the efficient and effective delivery of services to eligible clients.

• Operating motor vehicles or heavy equipment.
• Driving a County vehicle or a personal vehicle.

• Remaining in a stationary position, often standing or sitting for prolonged periods.
• Communicating with others to exchange information.
• Repeating motions that may include the use of wrists, hands and/or fingers.
• Assessing the accuracy, neatness, and thoroughness of the work assigned.
• Sedentary work that primarily involves sitting/standing.

• Must possess a valid and current Texas driver's license.
• Drug and Alcohol Policy applies to this job. Pre-employment drug/alcohol testing, Motor Vehicle Record (MVR), and criminal background checks are required.
• This position is covered by Civil Service; therefore, is subject to the Civil Service Rules and Regulations in addition to all other Webb County policies.

• If the applicant holds an out-of-state license, a State of Texas Driver’s License must be obtained prior to employment.

Webb County provides a variety of benefits available to employees.
Please visit the Risk Management website for more details.
https://www.webbcountytx.gov/RiskManagement/EmployeeBenefits/

The following list of benefits is offered only to benefits-eligible employees in Full-Time positions:

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Wellness Program
• Life Insurance
• Ancillary products
• Employee Assistance Program*
• Employee Clinic*
• Vacation and sick leave
  • Accrual rates increase based on years of service
• Sixteen (16) County-observed holidays and four (4) personal holidays
• Retirement benefits (TCDRS)**

• Available to ALL employees