JOB SUMMARY:

　　Performs eligibility work that requires a strong working knowledge andunderstanding of eligibility program rules and policies and operation of thecurrent proscribed eligibility computer program(s). Performs dutiesassociated with initial intake and ongoing eligibility determination forMedical Assistant Programs, as described in Colorado Staff Manuals,Volumes III, IVB, and VIII through the Department of Human Services orDepartment of Health Care Policy and Finance. Interprets rules and regulationsof all program areas. Facilitates and/or coordinates the processes andprocedures necessary to provide clients with assistance. Performs calculationsand accounting functions necessary to establish eligibility and to determinethe necessary steps to resolve client situations. Provides referral to othercommunity resources to assist clients. Bilingual English / Spanish is a plus.

　　ESSENTIAL JOB FUNCTIONS:

　　(The following duty statements are illustrative ofthe essential functions of the job and do not include other non-essential ormarginal duties that may be required. Our company reserves the right to modifyor change the duties or essential functions of this job at any time. Allresponsibilities may not be performed by all incumbents.)

　　Conducts initial and ongoing program eligibility interviews and assessments byphone, face-to-face and gathers information such as income and financialresources. Determines initial and ongoing eligibility for Medical AssistancePrograms as described in Colorado Staff Manuals, Volumes III, IV-B, andVIII through the Department of Human Services or Department of Health CarePolicy and Finance. Determines eligibility for Expedited Food Assistance.

　　Approves or denies applications, closes cases as necessary, and notifiesclients of decisions in writing. Transfers cases to the appropriateeligibility specialist, team, or closed caseload.

　　Assists clients in completing forms and obtaining the necessary documentationfor program participation. Assesses client needs and makes referrals to otheragency and community services.

　　Screens applications to verify programs being applied for. Uses computerizedsystems to research current and past assistance status and history. Sets upnew case files and properly categorizes household composition.

　　Maintains a working knowledge of the current proscribed eligibility computersystem. Performs data entry functions to ensure that required and relevantinformation is accurately entered intonumerous complex data systems. Processes change forms for continuedeligibility determination. As required, verifies all information throughcomputer data banks, pay stubs, contacts with employers and banks, etc.Ensures benefit calculations made by the current proscribed eligibilitycomputer program(s) are accurate in order to reduce/eliminate errors.

　　Manages workload and paper flow. Processes case changes as they occur. Ensuresthat all case documents are filed in the electronic case file appropriatelyand in a timely manner.

　　Completes required paperwork to restore benefits, provide retroactivepayments, and provide supplements. Establishes and computes recoveries andrestorations due as a result overpayment or underpayment; notifies fraudinvestigators when case information indicates that benefits may have beenreceived based on fraudulent information.

　　Informs recipients/applicants of rules and regulations. Explains rights andresponsibilities to clients and provides referrals to non-profit agencies andother service providers to facilitate a comprehensive solution to theclient's issues.

　　Maintains a working knowledge of program rules and regulations. Receives,researches, resolves and clears information on required program reports.Processes program sanctions. Identifies the level and kind of sanction.Provides sanction notification to the client being sanctioned.

　　Prepares cases for and a tends dispute resolution conferences, appealshearings, or other court cases in person or by telephone to represent thecounty and to testify to the facts of the case. Ensures documentation isdetailed and clear in the case file.

　　Provides customer service by responding to inquiries regarding programs andservices. Handles client complaints and provides needed information regardingprogram guidelines.

　　Shall engage in heavy public contact via client interviews and front windowcoverage.

　　May be subject to vulgar, offensive language and behaviors from the public.

　　Based on workload, may be required to participate in mandatory overtime;such overtime may include evenings and weekends.

　　Responsible for understanding and demonstrating proficiency in all aspects ofthe eligibility position including but not limited to: face-to-faceclient meetings on a walk-in basis, lobby/client interviews, processingof applications and redeterminations, pulling and returning calls, workingmail and anyother correspondence submitted by clients.

　　Communicates in a timely and responsive manner with internal teams,community organizations, providers, and State Staff.

　　Oral and written communications must be clear and effective.