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Eligibility Specialist

State of Maine
Full Time
Augusta, ME 04330
$20.73 - $24.21 an hour
Posted 2 days ago
Job description

Department of Health and Human Services (DHHS)

Opening Date: November 23, 2022

Closing Date: December 8, 2022

Job Class Code: 5073
Grade: 19 (Professional & Technical Services)
Salary: $20.73-$24.21/hourly*
  • Employees in this classification begin at Step 4 of the pay scale.
Position Number: 02022-7492

This is only open to those with promotional status in the Department of Health and Human Services


Job duties:

The position of Eligibility Specialist determines initial and continued eligibility for public assistance programs with the Long Term Care division. The position may also perform quality control work by reviewing eligibility decisions made by others. Work is done in a fast-paced environment that has high standards for customer service and program accuracy. The position gathers sensitive and personal information to make timely and accurate eligibility determinations. Strong interpersonal and conflict resolution skills are necessary as the Eligibility Specialist interacts with people from different walks of life and/or in various emotional states. Much of the work is done in a call center atmosphere.

Typical Duties:

  • Interview clients, obtains and assesses all necessary facts, data, supporting information, and documentation pertaining to the application or recertification for public assistance.
  • Evaluate information and applies allowable standards and criteria.
  • Explain program eligibility requirements, rules, regulations and individual rights and responsibilities to clients.
  • Reviews and analyzes information for accuracy; identifies inconsistencies; requests necessary documentation; verifies and validates data.
  • Answers inquiries and refers clients to various programs.
  • Identifies potential benefit overpayments, assesses cause for overpayment and makes referrals for recovery of benefits.
  • Identifies potential fraud and refers to the Fraud Investigation Recovery Unit.
  • Accurately enters data into an automated system and ensures accurate eligibility results.
  • Communicate verbally and in writing with clients, co-workers and other agencies.
  • Perform intermediate mathematical calculations.
  • Maintain confidentiality of all applicant and recipient information.

Minimum Qualifications:

To qualify, you must have a four (4) year combination of education, training, and/or experience in providing direct assistance to individuals or groups or deciding client eligibility in a business, legal or social services setting which demonstrates interviewing and data gathering skills to form judgments in eligibility determinations, claims resolution, transaction processing, insurance coverage and/or customer service requests - OR - a Bachelor’s Degree in social services, public or business administration, or other related fields.


Agency information:

The Department of Health and Human Services (DHHS) is dedicated to promoting health, safety, resilience, and opportunity for Maine people. The Department provides health and social services to approximately a third of the State's population, including children, families, older Mainers, and individuals with disabilities, mental illness, and substance use disorders. The Department also promotes public health, operates two state psychiatric hospitals, and provides oversight to health care providers.

The Office for Family Independence is responsible for administration of eligibility determination for a number of programs, including MaineCare, Temporary Assistance for Needy Families (TANF), Food Supplement, Fraud and Recovery, and Child Support.


Application Information:

Please submit all documents or files in a PDF or Word format.

For additional information about this position please contact Marcus Hatch at (207) 890-6810 or by email at [email protected] .

To request a paper application, please contact Ashley Smith at [email protected] . To apply, please upload a resume, cover letter, and transcript (transcript needed only if education is used to meet the minimum qualifications)

Benefits

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

  • Work-Life Balance – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave, and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
  • Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($10,150.80-$11,942.16 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.
  • Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
  • Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($350.40 annual value).
  • Retirement Plan – The State of Maine contributes 13.16% of pay to the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
  • Gym Membership Reimbursement – Improve overall health with regular exercise and receive up to $40 per month to offset this expense.
  • Health and Dependent Care Flexible Spending Accounts – Set aside money pre-tax to help pay for out-of-pocket health care expenses and/or daycare expenses.
  • Public Service Student Loan Forgiveness – The State of Maine is a qualified employer for this federal program. For more information, visit the Federal Student Aid office.
  • Living Resources Program – Navigate challenging work and life situations with our employee assistance program.
  • Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including fathers and adoptive parents—receive four weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.
  • Voluntary Deferred Compensation – Save additional pre-tax funds for retirement in a MaineSaves 457(b) account through payroll deductions.
  • Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.

Maine State Government is an Equal Opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We provide reasonable accommodations to qualified individuals with disabilities upon request.

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