Accurately determines eligibility for medical services for the Elderly and People with Disabilities. Interviews clients, documents information, gathers data, determines benefits, verifies case data, explains program benefits and requirements, provides information and referral services to clients, providers, agency staff and the general public. Reviews eligibility of clients for ongoing services.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with agency leave policy.
Obtains, verifies, and calculates all sources of income and resources to determine client financial eligibility. (10%)
Interviews clients or authorized representative to gather information to determine eligibility for benefits. (25%)
Conducts reviews to determine or verify eligibility or continued eligibility. (25%)
Documents case records using automated equipment to form a record for each client. (10%)
Explains program services and policies and makes referrals to agency programs, other state agencies, and community resources. (10%)
Develops payment plans to facilities to ensure accuracy of payments. (10%)
Monitors nursing facility records to verify discharges, admissions or related records to ensure facility compliance with state and federal standards. (5%)
Communicates with others (internally or externally) to provide, exchange, or verify information, answer inquiries, address issues, or resolve problems or complaints. Performs other duties as assigned. (5%)
Knowledge Skills Abilities:
Knowledge of agency programs, requirements and policies.
Knowledge of interviewing techniques to obtain highly personal information, make inquiries and resolve conflicting information. Knowledge of computers and use of internet, Microsoft Word and Outlook.
Skill in use of automated data systems. Skill in providing customer services.
Skill in communicating effectively both orally and in writing
Ability to communicate orally and in writing.
Ability to add, subtract, multiply and divide whole numbers and fractions, including use of decimals and computation of percentages.
Ability to listen to clients, elicit, relate and evaluate information; and interpret terms.
Ability to complete work within specified deadlines.
Ability to read, understand, interpret and apply a variety of interrelated instructions, such as those found in guidelines, agency, state and federal rules, regulations, policies and procedures.
Ability to establish priorities according to relative importance and deadlines; set goals; and manage time efficiently.
Ability to identify conflicting information provided by the clients and/or their responsible parties.
Ability to screen applications, verify eligibility criteria and determine case disposition.
Ability to establish rapport with clients, responsible parties and nursing home personnel.
Ability to maintain effective working relationships with others.
Registration or Licensure Requirements:
Initial Selection Criteria:
High School Diploma or GED equivalent required. Sixty (60) hours credit from an accredited college or university preferred. Two (2) years relevant work experience may be substituted for college credit.
Bilingual (English/Spanish) skills preferred, not required.
Current TIERS Knowledge preferred (ME I position) (6 months required – 1 year preferred) for MEPD II positions.
Experience to indicate a general understanding of the knowledge, skills, and abilities needed to perform duties.
Ability to work in a professional customer service environment required.
Prefer work experience in social service work: interviewing, counseling, public relations, loan processing, investigations; in the gathering of information; in programs which require applying complex policies to determine entitlements based on income; or in instructing, demonstrating, and interpreting policies to the public, clients, or others. OR relevant work experience working as a Clerk in eligibility programs, for example SNAP (Food Stamps) or TANF (cash assistance), medical eligibility, or similar entitlement programs; and education that demonstrates possession of the knowledge, skills, and abilities necessary for job performance will be considered.
This position is included in a career track series. This position will be filled at the entry level MEPD Specialist I / Salary Group B12. Persons hired into this position from outside the Health and Human Services Commission (including other HHSC agencies) are on initial probationary status for one year from hire date. This position career tracks to the MEPD Specialist II / Salary Group B13 which tenure (One year from Hire Date) and performance requirements are met. Based on training requirements and previous program eligibility experience, former Office of Eligibility Services (OES) employees may be considered for rehire at the MEPD Specialist II / Salary Group B13. Incumbents are automatically upgraded when tenure and performance requirements are met. Current MEPD Specialist II / B13 applicants, if selected, will maintain current job classification and salary group.
Office Location of Position To Be Filled: 408 N. Flournoy Rd, Alice Texas 78332
Req #: 213749
Position Number(s): 59105
In compliance with the American with Disabilities Act (ADA), HHS agencies will provide reasonable accommodations during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the AcessHR service center at 1-888-894-4747. If you are contacted for an interview and need accommodations to participate in the interview process, please notify the person scheduling the interview.