Eligibility Specialist- Adult Unit

Unit: Adult Categories | Reports to: Program Manager Adult | FLSA Status: Non-Exempt | Salary: $37,050.00/year

About the role

Determines initial and continuing eligibility for Health First Colorado (Medicaid), Food Assistance/SNAP, and Aid to the Needy Disabled (AND) Programs.

Responsibilities

• Process applications and verify information to approve or deny assistance based on program eligibility requirements outlined in state rules and regulations.
• Conduct verification through direct contacts, phone, email, and/or home visits.
• Inform applicants/recipients of program requirements, benefits, and appeals rights and procedures.
• Assist applicants in completing forms, securing documents, and providing verifications needed for application and recertification.
• Inform recipients of changes in laws or regulations affecting their eligibility or grant amounts.
• Approve or deny applications and communicate decisions within appropriate time frames.
• Interface daily with the County Benefit Management System (CBMS), ensuring accurate and complete data entry.
• Interpret and evaluate computer-generated data for case processing, including approvals, changes, denials, discontinuations, and case closures.
• Exercise prudent judgment in applying rules and regulations to ensure accuracy and verification of recipient information.
• Determine the need for recovery of funds or referral for fraud investigation; complete informational reports for suspected fraud.
• Verify statements through phone contacts, written requests, and collateral resources.
• Prepare for and testify at evidentiary or administrative hearings.
• Assess and refer clients to other community agencies for services such as housing and clothing.

Requirements

• High school diploma or GED; or one to three months of related experience and/or training; or equivalent combination of education and experience.
• Valid Driver’s License.
• Must pass the Colorado Benefit Management System (CBMS) test through the State SDC training system to gain system access.

Skills

• Proficiency in interviewing clients to obtain necessary information.
• Knowledge and understanding of confidentiality/privacy standards.
• Knowledge of community resources to assist clients.
• Negotiation skills to facilitate agreements.
• Proficiency in Microsoft Office.
• Computer skills to perform job tasks, including learning and operating DHS-specific software.
• Ability to perform basic arithmetic operations (addition, subtraction, multiplication, division) and compute rates, ratios, and percentages.
• Ability to communicate effectively in English, both written and verbal.
• Ability to maintain sensitive and confidential information.
• Ability to read, interpret, and follow safety rules, operating instructions, and procedure manuals.
• Ability to apply common sense understanding to carry out written and oral instructions.
• Ability to conduct research, verify information, and reconcile financial data.
• Ability to interpret routine reports and maintain required documentation.
• Ability to prepare documentation for Administrative Court hearings.
• Ability to work in a fast-paced, time-sensitive environment.
• Bilingual (Spanish) preferred but not required.

Physical Requirements

• Minimal physical effort generally required under typical office conditions.
• Ability to operate a computer keyboard efficiently, involving repetitive hand movements and fine coordination.
• Frequent use of hands to finger, handle, or feel objects, tools, or controls, and to reach with hands and arms.
• Ability to stand, sit for long periods, talk, and hear.
• Hearing and vision correctable to normal ranges; close-up vision and ability to adjust focus.
• Occasional stooping, bending, kneeling, crouching, carrying, twisting, pushing, and pulling light to moderate amounts of weight (up to 25 pounds).
• Ability to communicate both orally and in writing.
• Ability to reach and manipulate objects, tools, or controls.
• Noise level may vary from very quiet to noisy depending on the situation.
• Occasional requirement to drive in various weather conditions, both locally and throughout the state.