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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 #: 404-08-23

Closes: Open Until Filled

Location: Dallas, OR

Salary: Starting at $3,982 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.

PURPOSE OF JOB

Meets 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 Functions

1. Determine eligibility for participation in financial, medical, and SNAP benefits

2. Conduct annual reviews of financial eligibility for participation in financial, medical and SNAP benefit programs

3. Provides ongoing consumer maintenance

4. Provides additional assistance to consumers as needed

5. Promotes person centered services

6. Protects consumers and reduces Agency risk

7. Provides excellent service in a professional manner

1. Determine eligibility for participation in financial, medical and SNAP benefit programs by:

• Maintain electronic and paper consumer files.
• Interview individuals via phone or in person to gather necessary information.
• Assist applicant in obtaining verifications.
• Cover incoming calls on eligibility for unit, i.e. “Worker of the Day.”
• Explain benefits and resources available.
• Provide notification of eligibility decisions timely and completely as outlined in rules and policy.
• 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.
• Review application document for completeness (may include helping individual through application process).
• Apply program rules and policy to determine if individual qualifies for programs.
• Process forms and documents.

2. Conduct annual reviews of financial eligibility for participation in financial, medical and SNAP benefit programs

• Contact consumer for additional information or to clarify as necessary.
• Apply program rules and policy to determine if individual continues to qualify for program.
• Ensure consumer receives re-determination information.
• Process information, forms and documents between determinations to ensure consumer benefits are current.
• Review returned materials for completeness.
• Maintain electronic and paper consumer files.
• Provide notification of eligibility decisions timely and completely as outlined in rules and policy.

3. Provide ongoing consumer maintenance

• Adjust benefits as needed.
• Verify information.
• Receive, review and process updated information from consumers.

4. Provide additional assistance to consumers as needed

• Process other reports as necessary, such as reporting deceased consumers, monthly reports to manager on closed, denied and withdrawn cases. (FOR BILINGUAL POSITIONS ONLY)
• Process and review forms and data related to MMIS database.
• Attend consumer hearings and providing testimony as necessary.
• Provide addition resources and community referrals as appropriate.

Ensure Non-English speaking consumers receive services

• 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.
• Provide services to consumers whose primary language skills are non-English.
• Communicate with individuals whose primary language skills are non-English.

5. Promote person centered services

• Interact with the public, consumers, co-workers and others in a patient, respectful and culturally appropriate manner.
• Embrace and exhibit the Agency Mission and Core Values.
• 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 needed
• Understand the role of consumer choice.

6. Protects consumers and reduces Agency risk

• 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.
• Follow policies, regulations and requirements of project and Agency; document plan and progress as required.

7. Provides excellent service in a professional manner

• Meet the needs of consumers, follow through, meeting deadlines, and maintain skills and knowledge to perform the job.

• 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.);
• Exhibit good decision making, problem solving and work habits.
• Regular attendance to meet the demands of this job and provide necessary services.
• Exhibit good work habits, including organizational skills, regular attendance, working independently, seeking and offering assistance when needed.
• Apply the required knowledge and skills and exhibit critical thinking and problem solving.
• Meet quality standards in accuracy, judgment, timeliness and following policy and procedure.

Experience and Skills:

Minimum Qualifications - Education and Experience

A 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:

• Work 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.
• Bachelor’s degree in social sciences or any related field

(FOR BILINGUAL POSITIONS ONLY)

• Successful completion of a Language Proficiency Test

Knowledge, Skills, and Abilities

The 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 customers
• Organize and prioritize work to meet required time timeframes
• Speak, read, write, and understand English
• Collaborate and coordinate with others
• Exhibit good judgment, and use courtesy and tact
• Exhibit excellent interpersonal communication and listening skills
• Know and commit to abide by rules governing consumer confidentiality and mandatory reporting
• Follow verbal and written instruction
• Apply the knowledge and skills in a timely, accurate, and efficient manner to meet deadlines
• Process a high volume of work with critical deadlines
• Build relationships and network
• Multi-task

The successful applicant must have the following job-specific skills, including the ability to:

• Utilize general math skills
• Learn 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 work
• Learn and use database to maintain complete and timely files, including data entry and narration of ongoing work
• Meet quality work standards
• (For Bilingual) Successfully demonstrate the required level of oral and written proficiency for bilingual duties in identified language pair (English/Spanish, Russian, ASL, etc.)
• Learn available services of Agency and other community services
• Apply knowledge of program rules
• Interview and obtain general and financial information
• Understand the role of the individual’s preferences in care success
• Keep up with fast changing rules through training and resources provided by the Agency
• Use extensive business-English skills (grammar, spelling, and punctuation)
• Operate a personal computer, copier, fax machine, phone, and general office equipment, etc.

Other Requirements

The successful applicant must have the following skills, including the ability to:

• Commit to regular attendance as it is required to meet the demands of this job
• Maintain and share information according to privacy regulations
• Complete necessary work as assigned
• Secure and maintain a valid driver’s license in the state of Oregon, or an acceptable alternative means of transportation
• Pass a criminal background check successfully
• Support the agency’s mission, ethics, and values
• Serve as a mandatory reporter of suspected abuse of vulnerable populations as required by policy and regulation

WORK ENVIRONMENT/PHYSICAL DEMANDS

This 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 Specialist

Bilingual Eligibility Specialist

Position Number: varies

Salary Range: R19/R20 for bilingual

FLSA Status: Non-Exempt

Unit: Varies

Location: Varies

Reports to: Services Manager

Union Status: Represented

Last revision: May 2018

This 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.