Job Posting for Eligibility Specialist (Medicaid) at Union County, NC

General Statement

The Eligibility Specialist, under general supervision, performs tasks related to the determination of eligibility and providing ongoing caseload management for economic service assistance programs such as Food and Nutrition Services, Temporary Assistance to Needy Families (Work First), Childcare, Families and Children, and/or Adult Medicaid. Implements effective caseload management techniques; assesses the customer's need for services; and participates in staff and program development. Employee must exercise tact, courtesy, and good judgment in contact with county employees, outside organizations, and the general public. Employee must also establish and maintain effective relationships as necessitated by work assignments.

Essential Functions

Conducts interviews (face-to-face, by telephone and/or through third party verification) with customers utilizing established interviewing techniques to determine eligibility (also uses ex parte' information to determine eligibility) for economic services assistance; follows up with customers within established guidelines.

Responds to inquiries from clients and citizens regarding benefits, application process, and/or program eligibility.

Explains public assistance program requirements and options to client/applicant.

Assesses customers' needs, makes appropriate referrals and coordinates services available from other programs in a timely manner; provides guidance and direction in crisis situations; appropriately defuses emotions and fosters customer readiness to use available services and pursue self-sufficiency.

Computes and authorizes amounts of assistance for different programs.

Evaluates and verifies information and assesses the validity of customer documentation; applies federal, state, and county policies and procedures within prescribed time frames with a minimal number of errors, overdue applications, and case re-determinations.

Coordinates with other programs to ensure proper processing.

Documents case findings within established timeframes accurately to reflect customer's situation and to substantiate verification of all eligibility factors; initiates and updates data in multiple computer systems accurately (Compass and NC FAST).

Provides information to clients/applicants regarding programs, services, eligibility requirements and outcomes.

Identifies cases for investigation of potential fraud and submit appropriate fraud referral documentation.

Completes client re-certification for eligibility.

Assists in local and state hearings process as necessary.

Maintains and updates case records and management reports using computer skills and documentation.

Schedules unit eligibility activities, establishes priorities and complies with deadlines using effective time management and organizational skills; participates in appropriate training sessions to enhance job performance. Establishes activities and priorities appropriately; maintains current records and management reports which reflect an accurate accounting of caseload responsibility; appropriately utilizes and applies training received;

Maintains proficiency in researching the on-line integrated manual, job-aides, and administrative letters with the ability to apply the policy/procedures obtained from the respective sources; requests assistance/clarification of policy that may appear to be vague or unclear.

Understand and apply pertinent Federal, State and local codes, laws and regulations.

Ability to develop and maintain cooperative and courteous relationships with division employees, staffers and managers in other divisions, representatives from organizations, and the general public so as to maintain good will toward the division and project a good division image.

Assists supervisor with training of peers as requested.

May assists with community awareness presentations to community groups.

May temporarily serve as a lead worker; carrying out designated responsibilities utilizing established policies and procedures as requested.

Performs other related duties as assigned.

Qualifications

MINIMUM QUALIFICATIONS

Education and Experience:

High School Diploma or an acceptable equivalency diploma (GED) and two (2) years of paraprofessional, clerical, or other public contact experience.

Special Requirements:

Basic Excel knowledge.

PREFERRED QUALIFICATIONS

Education and Experience:

Associate’s Degree from an accredited college/university in Human Services Technology, Social Services, Business Administration, or a closely related curriculum and eligibility determination experience and three (3) years of paraprofessional, clerical, or other public contact experience; or equivalent combination of education and experience.

Special Requirements:

NC FAST or other eligibility determination system experience.

Fluent in Spanish and English.

Supplemental Information

PHYSICAL DEMANDS

Must be physically able to operate a variety of machinery and equipment including computers, typewriters, copiers, facsimile machines, calculators, printers, telephone, etc. Must be physically able to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting, but may involve walking or standing for periods of time.

WORK ENVIRONMENT

Work is performed in a dynamic environment that requires the need to be sensitive to change and responsive to changing goals, priorities, and needs.

INSURANCE PROGRAMS

HEALTH INSURANCE

All full-time employees and their eligible dependents can participate on the first day of the first full month of employment. You must sign up for coverage within your first 30 days of employment or wait until the annual enrollment period. Health Reimbursement Account Preventative Care Coverage Prescription Coverage Vision Coverage

DENTAL INSURANCE

All full-time employees and their eligible dependents can participate on the first day of the first full month of employment. You must sign up for coverage within your first 30 days of employment or wait until the annual enrollment period.

LIFE INSURANCE

Basic Term life Insurance in the amount of one times the annual salary is provided for all full-time and benefitted part-time employees. Additional coverage is available for purchase through payroll deduction for the employee and eligible dependents.

FINANCIAL PROGRAMS

RETIREMENT

Membership in the North Carolina Local Government Employees Retirement System is a requirement for all full-time and benefitted part-time employees. Employees contribute six percent (6%) of their annual compensation before it is taxed. If you leave County service before retirement, you may withdraw your retirement contributions or elect to freeze your contributions in anticipation of future local government employment. If you have five (5) years of service, you are 100% vested in the NCLGERS.

NC401(k)

The NC401(k) supplemental retirement program is available to full-time and benefitted part-time employees. The County establishes this 401(k) account for each eligible employee and makes a five percent (5%) contribution based on biweekly earnings. Employees may elect to make voluntary contributions through payroll deduction.

457 DEFERRED COMPENSATION

The 457 Deferred Compensation program is available to all employees through payroll deduction. Deferred compensation is a voluntary investment plan to supplement retirement income and to defer taxable income.

FLEXIBLE SPENDING ACCOUNTS

Options are available to regular full-time and benefitted part-time employees who wish to use pre-tax dollars for eligible medical, pharmacy, dental, vision, and daycare expenses. The Flex Debit Card program gives you instant access to your account funds.

Health Care Spending Account - Section 125 of the IRS Code allows yearly voluntary enrollment to set aside pre-tax dollars for eligible health care expenses.

Dependent Care Spending Account - Section 125 of the IRS Code allows yearly voluntary enrollment to set aside pre-tax dollars for eligible dependent care expenses.

DIRECT DEPOSIT

Deposit of your paycheck will be made to checking or savings accounts in a bank of your choice.

CREDIT UNION

Local Government Federal Credit Union membership is available to all employees. Once you join, you can remain a member for as long as you choose. Immediate family members such as: spouse, children, stepchildren, brothers, sisters and parents can all become members.

TRUIST
No Overdraft Fees
$100 Negative Balance Buffer
Online and Mobile Banking with Bill Pay

LEAVE PROGRAMS

VACATION LEAVE

Vacation leave is accrued based on creditable years of service in the Local Government Employees Retirement System.

SICK LEAVE

For full-time County employees, sick leave accrues at eight (8.0) hours per month. Benefitted part-time employees accrue prorated sick leave based on a percentage of the full-time rate. Your unused sick leave balance can be applied as creditable service toward a service retirement under the guidelines of the NCLGERS.

SICK LEAVE TRANSFER FROM OTHER AGENCIES

Unused sick leave earned from another North Carolina Governmental Agency and/or entity, will be accepted and transferred to the County as follows: twelve (12) sick leave days will be transferred and added to the employees active sick leave balance after completion of six (6) months of employment. The remaining balance of sick leave documented for transfer at the time of employment will be recorded in the employees permanent personnel file. On the fifth anniversary of employment with the County, the remaining balance of transferred sick leave will be added to the employees active sick leave balance.

HOLIDAYS

There are 11 County recognized holidays per year with 1 floating holiday available.

MILITARY LEAVE

Annual Training - 10 paid workdays granted.

Active Duty - 20 paid workdays granted.

CIVIL LEAVE

Paid leave is provided to full-time or regular part-time County employees called for jury duty or as a witness of the court for the federal or state government, or a subdivision thereof.

FAMILY & MEDICAL LEAVE ACT

Federal law provides job protection and continuation of existing paid health insurance during 12 weeks of leave, paid or unpaid, to an eligible employee for qualifying events. These events can include birth or adoption, and serious illness of an immediate family member, or of the employee.

PAID PARENTAL LEAVE

Parental Leave provides the employee paid leave for the first eight weeks of approved FML for the birth of a son or daughter, or placement with the employee of a son or daughter for adoption or foster care.

ADMINISTRATIVE LEAVE

Educational Leave is available to regular full-time and benefitted part-time employees when participating in a job-related, short course, such as an update, not to exceed ten (10) consecutive working days.

VOLUNTEER TIME OFF

Volunteer Time Off will provide employes with 16 hours of paid time per calender year to volunteer at approved Union County community partner agencies.

OTHER PROGRAMS

EMPLOYEE ASSISTANCE PROGRAM

The Employee Assistance Program is open to all employees and their dependents. It is a confidential service provided at no cost to the employees of the County. EAP provides certified counselors who administer assessment and brief therapy to employees who want help with a variety of personal and work-related issues such as stress, parenting concerns, grief, alcohol/drug use, family problems, financial concerns, and work-related problems.

AQUATIC AND FITNESS CENTER

We believe that staying healthy is more than just exercising regularly and eating well. Individual and family discount membership and monthly dues are available to full-time and benefitted part-time employees through payroll deduction.

NATIONAL COLLEGE SAVINGS PROGRAM

The National College Savings Program is open to all employees. The Program is designed to provide certain tax advantages, encourage and facilitate saving to pay the costs of attending eligible institutions.

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Eligibility Specialist (Medicaid)

Job Posting for Eligibility Specialist (Medicaid) at Union County, NC

General Statement

Essential Functions

Qualifications

Supplemental Information

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