Eligibility Specialist III

Salary : $55,307.20 - $74,152.00 Annually
Location : Hollister
Job Type: Full-Time
Job Number: MSS04715
Department: San Benito County Health and Human Services Agency
Opening Date: 10/21/2024
Closing Date: 11/5/2024 11:59 PM Pacific
Position Information
Eligibility Specialist III
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. Incumbents demonstrate advanced knowledge of eligibility regulations, procedures and eligibility software systems. Other assignments may include performing quality control and/or quality assurance reviews, participating in early fraud prevention programs, representing the County in administrative appeals and fair hearings and/or performing other specialized assignments and related work as required.
The Eligibility Specialist III differs from the Eligibility Supervisor in that the latter directly supervises a unit of Eligibility Specialists. The class of Eligibility Specialist III is distinguished from the Eligibility Specialist II as the latter requires a higher level of supervision and the Eligibility Specialist III is assigned lead specialist duties or special assignments with a greater degree of independent judgment.
SUPERVISION EXERCISED AND RECEIVED
Incumbents in the Eligibility Specialist III classification receive supervision from an Eligibility Supervisor or other manager. An Eligibility Specialist III has no responsibility for direct supervision of others, but may provide lead direction to other Eligibility Specialists.
Examples of Duties

• 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

EMPLOYMENT STANDARDS
Knowledge of:

• General goals and purpose of public social services programs
• Laws, rules, regulations, policies and procedures governing eligibility for diverse public assistance programs and related case administrative techniques
• Methods and techniques of conducting an investigative interview and information gathering
• Computer terminology and computer keyboard arrangement
• Principles of training and staff development
• Modern office practices, methods and procedures
• Record keeping practices and procedures
• Principles of mathematical calculations
• Intricacies of health insurance plans and medical health plan options and associated terminology
• Regulations and rules regarding household filing status related to the Affordable Care Act
• Cultural and human behavior, including knowledge of self, to interact effectively with clients and staff
• Principles and practices of effective customer service
• Structure and content of the English language including the meaning and spelling of words, rules of composition and grammar
• Modern equipment and communication tools used for business functions and program, project and task coordination
• Computers and software programs (e.g., Microsoft software applications) to conduct research, assess information and/or prepare documentation

Ability to:

• Lead, direct and train other eligibility staff
• Evaluate and make appropriate recommendations and corrections on selected cases
• Determine appropriate course of action in emergency situations
• Apply the laws, rules and regulations governing eligibility and grant determination for multiple public assistance programs and the case administration of these programs
• Identify available resources, and communicate with others to obtain and verify information concerning eligibility
• Use fact finding techniques and perform in-depth and interactive interviewing
• Make referrals to appropriate agencies and social service programs
• Detect and evaluate potential fraudulent situations
• Analyze and interpret written, numerical and verbal data from various sources
• Utilize multiple electronic information, social services systems and analyze and interpret such information
• Enter data accurately into a computerized system
• Navigate through computer screens and effectively use computer systems, software applications and modern business equipment to perform a variety of work tasks
• Identify when computer output is incorrect and make corrections
• Process cases manually as required
• Plan and organize caseload/workload to ensure work is completed in accordance with regulations relating to eligibility and timeliness
• Function effectively in a system with strict deadlines and constant changes
• Read, understand, apply and explain complicated and detailed correspondence and reports, regulations and policy directives
• Perform a variety of mathematical computations accurately and rapidly
• Prepare clear, concise and accurate records and reports
• Explain complex rules and programs so they can be understood by people of diverse socio-economic, cultural and educational backgrounds
• Gather, record and correctly evaluate IRS tax filing data, income and additional necessary information required for the determination of eligibility for one or more programs
• Explain health insurance plan options and plan details available to clients through the Affordable Care Act
• Review a variety of tax documents to obtain needed household filing information
• Explain health care reform tax credit implications to clients
• Refer clients to other community services as needed
• Assess and manage difficult and hostile persons or situations; or call for intervention when appropriate
• Interact with people, in a courteous manner, both in person, on the telephone, by mail or email communication
• Work in a fast-paced, professional office environment and prioritize a wide range of duties with varying time requirements to ensure timely completion
• Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax
• Establish and maintain cooperative working relationships with the public and staff
• Follow written and oral directions and instructions

Minimum Qualifications
Eligibility Specialist III
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.
Supplemental Information
ADDITIONAL INFORMATION

• A valid driver's license may be required at the time of appointment and employees may also be required to drive their own car, provide proof of car insurance, and a DMV clearance. Individuals who do not meet this requirement due to a disability will be reviewed on a case-by-case basis.
• The San Benito County Health and Human Services Agency requires pre-employment fingerprinting as a part of the background investigation for all positions.
• Government agencies accessing US government information, which include federal tax information must ensure that background investigation requirements for all agency employees and contractors that have access to federal tax information are consistent to the IRS background investigation requirements for access to federal tax information. Background checks are required and must be repeated every 5 years. Background requirements consist of three components which include fingerprinting, citizenship verification and local law enforcement checks.

EXAMINATION INFORMATION
TRAINING & EXPERIENCE EXAMINATION - WEIGHTED 100%
The Training & Experience Examination is designed to elicit a range of specific information regarding each candidate's knowledge, skill, abilities, and potential to effectively perform the duties relative to the classification. Responses to the questionnaire will be assessed based on pre-determined rating criteria. All applicants must complete the entire examination to receive a score. In order to obtain a position on the eligible list, candidates must receive a minimum rating of 70% on the examination.
Examination administration and processing time is approximately two weeks after the closing date of the job bulletin.
If conditions warrant, an Experience and Education examination may be conducted in lieu of the Training and Experience examination. Please review the Experience and Education examination information below:
EDUCATION & EXPERIENCE EXAMINATION - WEIGHTED 100%
The Education & Experience examination is based solely upon information provided from the application and supplemental information (e.g., resumes, transcripts). Information provided from the application and supplemental information will be assessed compared to a standard developed in relation to the elements of the. Special care should be taken to submitting a complete description of your education and experience relevant to the typical tasks, scope, and minimum qualifications stated on this bulletin. Supplemental information will be accepted, but competitors should read this bulletin carefully to determine what kind of information will be useful to those individuals completing the evaluation. In order to obtain a position on the eligible list, candidates must receive a minimum rating of 70% on the examination.
Examination administration and processing time is approximately two weeks after the closing date of the job bulletin.
ELIGIBLE LIST INFORMATION
A departmental open eligible list will be established for the county of San Benito. The list will be utilized for 12 months after it is established unless the needs of the service and conditions of the list warrant a change in this period.
RETEST PERIOD
Once you have taken the examination, you may not retest for SIX (6) MONTHS from the established eligibility date.
SPECIAL TESTING ARRANGEMENTS
Special testing arrangements may be made to accommodate applicants for disability, military, or religious reasons. If you require such arrangements, please contact CalHR at or 916-909-3701 upon notification that your application has been approved. Documentation from medical, military, school or church officials outlining the accommodation request must be received by our office a minimum of five business days prior to a scheduled examination.
EDUCATION DOCUMENTS
If you are using education to meet the minimum qualifications, you must attach your transcripts to your application. Applicants with foreign transcripts must provide a transcript evaluation that indicates the number of units to which the foreign course work is equivalent. Transcripts and evaluations may be unofficial; official transcripts may be required upon appointment. Please redact birthdates and social security numbers.
GENERAL INFORMATION
This position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States without the need for visa sponsorship by the start date of employment.
MSS reserves the right to revise the examination plan to better meet the needs of the recruitment if the circumstances under which this examination was planned change. Such revision will be in accordance with civil service laws and rules and all competitors will be notified.
If you meet the requirements stated on this bulletin, you may take this examination. Your performance in this examination will be rated against predetermined rating criteria. All competitors who pass will be added to the eligible list. Meeting the entry requirements does not assure success in the examination or placement on the eligible list.
General Qualifications: Applicants must possess essential personal qualifications including integrity, initiative, dependability, good judgement, the ability to work cooperatively with others, and a state of health consistent with the ability to perform the assigned duties of the class. A medical examination may be required. As part of the hiring process, a background investigation may be required.
EQUAL EMPLOYMENT OPPORTUNITY
The Merit System Services program is committed to equal employment opportunity for all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
ABOUT SAN BENITO COUNTY
San Benito County is in the Coast Range Mountains in California, only 45 minutes from the Pacific Ocean, bordering Santa Clara County and adjacent to the San Francisco Bay Area. The County enjoys a high comfort rating, with an average of 262 sunny days per year and mild temperatures year-round. Another aspect of the comfort level is the low crime rate, which falls anywhere from below to significantly below the national average in all measured categories. One of the historic California missions, San Juan Bautista is in San Benito County, as well as numerous quaint towns and communities. Within the County, there are 12 school districts, and several private, religious and charter schools, all providing students with a quality education. Residents and visitors also enjoy a myriad of outdoor activities here, at Pinnacle National Park, championship golf courses, skydiving, cycling, geological walks and is reputed to sport the best views in California.
Merit System Services does not negotiate or determine the benefits or salaries for positions offered by its partners. For more information about benefits or salaries, please visit the listed county or child support office's website or contact their human resources department.