eligibility counselor

State of South Carolina

<div><div><div><h2 class="jobSectionHeader">Job Responsibilities</h2></div> 
<div> 
<div>*This is a Temporary Grant position.*</div><div> 
The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.</div><div></div><div> 
This position is located in Eligibility, Enrollment and Member Service (EEMS) Processing Centers, Spartanburg County.</div><div>
This is an in-office role and not a telecommute or remote position.</div> 

Are you the One? We are looking for an Eligibility Specialist II (MAGI) who will determine/re-determine Medicaid eligibility according to Medicaid policies and procedures. This position collects and evaluates documentation from applicants to determine individual and family eligibility for the program. Eligibility Specialists complete all assigned eligibility determinations, reviews, and changes in an accurate and timely manner.<ul><li>
Uses various information sources, electronic tools, and systems provided by the Department to collect, assemble, evaluate, and act upon information provided by applicant/beneficiaries and third parties to make timely eligibility determinations, reviews, and changes of circumstance. Follows policies and procedures for the collection and analysis of applications and documentation and collects additional information for beneficiaries as necessary with the least burden to the applicant/beneficiary as possible. Performs follow-up activities in an efficient and effective manner, using the communication method most appropriate for obtaining outstanding information. Documents all notes and steps clearly and completely for review and hand-off to other specialists.</li><li>
Demonstrates proficiency in utilizing all processes, policies, procedures, and system updates to ensure that all eligibility determinations, reviews, and changes are completed accurately with satisfactory documentation. Makes accurate determinations of eligibility based on the rules and standards detailed by the Department and defined in written performance standards. Resolves discrepancies in case determinations or documentation a timely manner. Follows appropriate escalation processes as outlined in eligibility process documentation. Labels all documentation, records decision and notes clearly and accurately in the appropriate systems of record.</li><li>
Maintains a professional demeanor and communication style, ensuring that communication and interactions with co-workers, supervisors, and beneficiaries is clear, polite, and concise. Participates in customer service and privacy training and ensures that confidential or private information is maintained in accordance with State and Federal law as articulated through departmental policies and training.</li><li>
Attends all mandatory meetings, trainings, and events as directed by supervisory staff and agency leadership. Maintains awareness of and complies with all agency policies, to include privacy, confidentiality, standards of conduct, performance, leave and compensation, vehicle use and travel, and financial controls. Maintains appropriate certification and training to perform emergency management evacuation and shelter duties as necessary. Performs other duties as assigned by supervisory staff and agency leadership.</li></ul><div>
The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:</div><ul><li>
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.</li><li>
15 days annual (vacation) leave per year.</li><li>
15 days sick leave per year.</li><li>
13 paid holidays.</li><li>
State Retirement Plan and Deferred Compensation Programs.</li></ul></div> 

<div><h2 class="jobSectionHeader">Minimum and Additional Requirements</h2></div>
<div>A high school diploma and relevant program experience in customer services, social services, human services, and/or Medicaid processing.
A bachelor's degree may be substituted for the required program experience. 
Additional Requirements:<ul><li>
Overtime and/or weekend work with Deputy approval.</li><li>
Sitting or standing for long periods of time.</li><li>
Lifting requirements: 20 lbs.</li></ul></div>
<div><h2 class="jobSectionHeader">Preferred Qualifications</h2></div>
<div><ul><li>Eligibility Specialists must have a familiarity with computers, standard Microsoft Office software, internet browsers, and the ability to read, write, and speak English in a clear and concise manner.</li><li>
Must be able to perform basic mathematical computations.</li><li>
Eligibility Specialists must be able to work in a professional office environment with a diverse group of teammates and provide excellent customer service either face to face, telephonically or through written communication.</li><li>
Eligibility Specialists must be able to learn, retain, and apply information about federal rules and standards for processing Medicaid eligibility determinations.</li><li>
Specialists must maintain productive workspaces and must perform tasks in an effective manner to ensure the completeness, accuracy, and timeliness of eligibility determinations.</li></ul></div>
<div><h2 class="jobSectionHeader">Additional Comments</h2></div>
<div>Please complete the State application to include all current and previous work history and education. A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail. 
 
The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.</div></div></div>

Eligibility Specialist II (MAGI) / 61100189TG

<div><div><div><h2 class="jobSectionHeader">Job Responsibilities</h2></div> 
<div> 
<div>The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.</div><div></div><div> 
This position is located in Eligibility, Enrollment and Member Service (EEMS) Processing Centers, Spartanburg County. 
This is an in-office role and not a telecommute or remote position.</div><div> 

Are you the One? We are looking for an Eligibility Specialist II (LTCW) who is the front-line of beneficiary access to the Medicaid program. This position collects and evaluates documentation from applicants to determine individual and family eligibility for the program. Eligibility Specialists ensure the integrity of the Medicaid program by completing all eligibility determinations, reviews, and eligibility changes in an accurate and timely manner. In addition to meeting minimum standards for timely determinations in accordance with the Department&rsquo;s EPSM, serves as a subject matter expert and first tier escalation authority for individuals on their team.</div><ul><li>
Uses various information sources, electronic tools, and systems provided by the Department to collect, assemble, evaluate, and act upon information provided by applicant/beneficiaries and third parties to make timely eligibility determinations, reviews, and changes of circumstance. Follows policies and procedures for the collection and analysis of applications and documentation and collects additional information for beneficiaries as necessary with the least burden to the applicant/beneficiary as possible. Performs follow-up activities in an efficient and effective manner, using the communication method most appropriate for obtaining outstanding information in a timely manner. Documents all notes and steps clearly and completely for review and hand-off to other specialists.</li><li>
Demonstrates proficiency in utilizing all processes, policies, procedures, and system updates to ensure that all eligibility determinations, reviews, and changes are completed accurately with satisfactory documentation. Makes accurate determinations of eligibility based on the rules and standards detailed by the Department and defined in written performance standards. Resolves discrepancies in case determinations or documentation a timely manner. Follows appropriate escalation processes as outlined in eligibility process documentation. Labels all documentation, records decision and notes clearly and accurately in the appropriate systems of record.</li><li>
Maintains a professional demeanor and communication style, ensuring that communication and interactions with co-workers, supervisors, and beneficiaries is clear, polite, and concise. Participates in customer service and privacy training and ensures that confidential or private information is maintained in accordance with State and Federal law as articulated through departmental policies and training.</li><li>
Attends all mandatory meetings, trainings, and events as directed by supervisory staff and agency leadership. Maintains awareness of and complies with all agency policies, to include privacy, confidentiality, standards of conduct, performance, leave and compensation, vehicle use and travel, and financial controls. Maintains appropriate certification and training to perform emergency management evacuation and shelter duties as necessary. Performs other duties as assigned by supervisory staff and agency leadership.</li></ul><div>
The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:</div><ul><li>
Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.</li><li>
15 days annual (vacation) leave per year.</li><li>
15 days sick leave per year.</li><li>
13 paid holidays.</li><li>
State Retirement Plan and Deferred Compensation Programs.</li></ul></div> 

<div><h2 class="jobSectionHeader">Minimum and Additional Requirements</h2></div>
<div>A high school diploma and experience in customer services, social services, human services, and/or Medicaid processing.
A bachelor's degree may be substituted for the required program experience. 
Additional Requirements:<ul><li>
Overtime and/or weekend work with Deputy approval.</li><li>
Sitting or standing for long periods of time.</li><li>
Lifting requirements: 20 lbs.</li></ul></div>
<div><h2 class="jobSectionHeader">Preferred Qualifications</h2></div>
<div><ul><li>Eligibility Specialists must have a familiarity with computers, standard Microsoft Office software, internet browsers, and the ability to read, write, and speak English in a clear and concise manner.</li><li>
Must be able to perform basic mathematical computations.</li><li>
Eligibility Specialists must be able to work in a professional office environment with a diverse group of teammates and provide excellent customer service either face to face, telephonically or through written communication.</li><li>
Eligibility Specialists must be able to learn, retain, and apply information about federal rules and standards for processing Medicaid eligibility determinations.</li><li>
Specialists must maintain productive workspaces and must perform tasks in an effective manner to ensure the completeness, accuracy, and timeliness of eligibility determinations.</li><li>
Demonstrates high performance standards.</li></ul></div>
<div><h2 class="jobSectionHeader">Additional Comments</h2></div>
<div>Please complete the State application to include all current and previous work history and education. A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position. Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online. All correspondence from the Office of Human Resources will be through electronic mail. 
 
The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.</div></div></div>

Eligibility Specialist II (LTCW) / 61059453

Talladega Clay Randolph Child Care Corporation

POSITION TITLE: Eligibility Case WorkerWORKING HOURS: 8:00 A.M.-4:30 P.M., Monday - FridaySPECIFIC RESPONSIBILITIES:Accountable to Eligibility Supervisor/Region SupervisorI. EligibilityA. Process application and determine eligibility for childcare subsidy.B. Travel to secondary regional offices to conduct eligibility interviewsC. Obtain and document of all points of eligibility.D. Explain participation and fee requirements.E. Prepare and issue appropriate notification.F. Respond to all reported client/provider changes and take appropriate action.G. Enter clear and concise history narratives at each client/provider contact.H. Maintain and update all client/provider case records.I. Prepare and calculate client/provider overpayment claims.J. Explain and document instances of non-compliance.K. Document annual provider registration.L. Process monthly reimbursement payments.M. Monitor enrollment attendance and take appropriate action.N. Maintain waiting list records.II. Resource and Referral CounselingA. Provide accurate and nonbiased provider information.B. Explain and document Parental Choice.C. Disseminate Department approved consumer education materials.III. GeneralA. Maintain confidentiality regarding children, families and childcare providers.B. Assume duties as they become necessary for the efficient operation of the agency.C. Demonstrate a courteous, respectful attitude to all clients and providers.D. Abide by the TCR Customer Service Policy.EDUCATIONAL AND EXPERIENCE REQUIREMENTS: High school diploma or GED (Some College) Experience in public contact, clerical and computer application including Microsoft Word and Outlook. Must possess strong communication skills and sensitivity to needs of low-income families. Must demonstrate a command of grammatically proper written and spoken English. Must maintain confidentiality of information regarding children and families. Good attendance is critical.Job Type: Full-timePay: $18.50 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Ability to Commute:<ul><li>Gadsden, AL 35903 (Preferred)</li></ul>Ability to Relocate:<ul><li>Gadsden, AL 35903: Relocate before starting work (Preferred)</li></ul>Work Location: In person

Eligibility Caseworker

Texas Health and Human Services Commission

<div></div><div><div><div><div><div>Date: Mar 19, 2026
</div></div></div></div><div><div><div><div>Location:
SCHERTZ, TX
</div></div></div></div><div><div><div><div>Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. 


Functional Title: Eligibility Advisor I - Temporary 
Job Title: Eligibility Advisor I 
Agency: Health &amp; Human Services Comm 
Department: Ops Virtual Interviewing Ctrs 
Posting Number: 15109 
Closing Date: 04/02/2026 
Posting Audience: Internal and External 
Occupational Category: Community and Social Services 
Salary Range: $2,953.25 - $4,365.66 
Pay Frequency: Monthly 
Salary Group: TEXAS-B-13 
Shift: Day 
Additional Shift: 
Telework: Eligible for Telework 
Travel: Up to 10% 
Regular/Temporary: Temporary 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Nonexempt 
Facility Location:
 
Job Location City: SCHERTZ 
Job Location Address: 109 WINDY MEADOWS DR 
Other Locations:
 
MOS Codes: No military equivalent 
Brief Job Description: 


This is a temporary position that is expected to end on 08/31/2027. Temporary employees may be eligible to transfer to a regular status vacant position, contingent upon regular status position availability, tenure, and job performance. 


Are you a highly motivated, compassionate and dedicated individual looking for a rewarding career assisting the most vulnerable citizens of Texas in need of food, medical care, cash assistance and other social services? 


If so, the Texas Health and Human Services Commission (HHSC) Access and Eligibility Services (AES) division is looking for individuals who want to join an exciting, dynamic team working in a high-performing and innovative environment. AES provides an integrated and streamlined approach to connect individuals to services and supports that: reduce institutionalization, allow individuals to remain in their communities, and promote economic and personal self-sufficiency. AES is built upon its&rsquo; core values of respect, ownership, collaboration, and integrity with a goal of delivering best-in-class customer service to clients and stakeholders. 

Our staff are well organized, able to multi-task, possess the ability to learn policy regulations, able to thrive in a challenging, fast-paced, and evolving environment, have good communication skills, a positive attitude, strong work-ethic and a desire to help others. If you also possess these skills, then we are looking for you. 


We want you to join our team! 


The Eligibility Advisor I position consists of three job classifications; Eligibility Advisor, Medical Eligibility Specialist, and Hospital Based Worker that establish eligibility for different financial and medical programs. These include the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid for the Elderly and People with Disabilities (MEPD) and Medicaid. 


Essential Job Functions (EJFs): 


As an Eligibility Advisor I, you will receive paid, formal, training to perform the following essential job functions:
<ul>
<li>Interview applicants and recipients in person or by inbound or outbound telephone calls to obtain pertinent financial and personal information to determine financial eligibility for public assistance programs.</li>
<li>Evaluate data from various electronic and other sources to enter information into a computer-based eligibility system.</li>
<li>Compute and authorize benefits based on eligibility determination.
</li><li>Process work in accordance with state and federal regulations and established procedures, guidelines, and timeframes.</li>
<li>Perform other duties, as assigned.
</li></ul>Must be able to work overtime, as required by management, outside of normal hours of operation, which may include weekends when called upon.
Must be able to work in a highly stressful and fast-paced environment under constant pressure to meet required deadlines. 


Knowledge, Skills and Abilities (KSAs): 


In addition to the above listed functions, the following knowledge, skills, and abilities are needed:
<ul>
<li>Use fact-finding techniques to obtain, relate and evaluate information provided by applicants.</li>
<li>Read, understand, apply, and explain detailed regulations and policies.
</li><li>Perform basic arithmetic functions.</li>
<li>Manage time efficiently by establishing priorities in accordance with importance of deadlines.</li>
<li>Establish and maintain effective work relationships with others.
</li><li>Ability to communicate effectively both verbally and in writing.
</li><li>Follow written and oral directions and instructions.
</li><li>Operate computers to perform data entry and basic office software use such as Microsoft Word, Outlook, and Excel.</li>
</ul>
General knowledge and proficiency with computers and related technologies, such as software, hardware, operating systems, and typing skills.
Using Microsoft Teams and potentially soft phone technology is part of the everyday job expectations. 

Registrations, Licensure Requirements or Certifications: 


N/A 


Initial Screening Criteria: 


Applicants must meet the following education and experience requirements: 


Education:
High School Diploma or GED equivalent is required.
Sixty (60) semester or ninety (90) quarter hours from an accredited college or university is preferred. 

Experience:
One (1) year of customer service experience with public contact which can include retail, call center, clerical, hospitality, banking, receptionist, or similar customer service experience.
Thirty (30) semester or forty-five (45) quarter hours from an accredited college or university may be substituted for one (1) year of required experience. 


Experience in an environment interviewing clients and gathering personal information in-person or over the phone is preferred. 


Additional Information: 


Upon hire, the selected candidate will be required to sign a Temporary Employment Agreement. Temporary employees may be eligible to transfer to a regular status vacant position, contingent upon regular status position availability, tenure, and job performance. 


This posting may be used to fill positions in other locations within the region, as vacancies occur. 


Access and Eligibility Services Field Office normal hours of operation are Monday-Friday 8:00am to 5:00pm. Employees may be required to work overtime, as required by management, outside of normal hours of operation, which may include weekends. 

Applicants selected for hire will be required to pass a fingerprint criminal history background check. 


Applicants may not have a history of substantiated fraudulent activity against HHSC or any program it administers. Applicants who have a non-fraud overpayment with an outstanding balance must agree to repay the overpayment balance as a condition of employment.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC. 


Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor&rsquo;s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions. 


ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. 


Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. 


HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs. 
</div></div></div></div> 
Nearest Major Market: San Antonio</div>

Eligibility Advisor I - Temporary

POSITION TITLE: Eligibility Case WorkerWORKING HOURS: 8:00 A.M.-4:30 P.M., Monday - FridaySPECIFIC RESPONSIBILITIES:Accountable to Eligibility Supervisor/Region SupervisorI. EligibilityA. Process application and determine eligibility for childcare subsidy.B. Travel to secondary regional offices to conduct eligibility interviewsC. Obtain and document of all points of eligibility.D. Explain participation and fee requirements.E. Prepare and issue appropriate notification.F. Respond to all reported client/provider changes and take appropriate action.G. Enter clear and concise history narratives at each client/provider contact.H. Maintain and update all client/provider case records.I. Prepare and calculate client/provider overpayment claims.J. Explain and document instances of non-compliance.K. Document annual provider registration.L. Process monthly reimbursement payments.M. Monitor enrollment attendance and take appropriate action.N. Maintain waiting list records.II. Resource and Referral CounselingA. Provide accurate and nonbiased provider information.B. Explain and document Parental Choice.C. Disseminate Department approved consumer education materials.III. GeneralA. Maintain confidentiality regarding children, families and childcare providers.B. Assume duties as they become necessary for the efficient operation of the agency.C. Demonstrate a courteous, respectful attitude to all clients and providers.D. Abide by the TCR Customer Service Policy.EDUCATIONAL AND EXPERIENCE REQUIREMENTS: High school diploma or GED (Some College) Experience in public contact, clerical and computer application including Microsoft Word and Outlook. Must possess strong communication skills and sensitivity to needs of low-income families. Must demonstrate a command of grammatically proper written and spoken English. Must maintain confidentiality of information regarding children and families. Good attendance is critical.Job Type: Full-timePay: $18.50 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Ability to Commute:<ul><li>Huntsville, AL 35811 (Preferred)</li></ul>Ability to Relocate:<ul><li>Huntsville, AL 35811: Relocate before starting work (Preferred)</li></ul>Work Location: In person

<div></div><div><div><div><div><div>Date: Mar 19, 2026
</div></div></div></div><div><div><div><div>Location:
SILSBEE, TX
</div></div></div></div><div><div><div><div>Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. 


Functional Title: Eligibility Advisor I - Temporary 
Job Title: Eligibility Advisor I 
Agency: Health &amp; Human Services Comm 
Department: TW Reg 05 EOAPD 
Posting Number: 15074 
Closing Date: 04/02/2026 
Posting Audience: Internal and External 
Occupational Category: Community and Social Services 
Salary Range: $2,953.25 - $4,365.66 
Pay Frequency: Monthly 
Salary Group: TEXAS-B-13 
Shift: Day 
Additional Shift: 
Telework: Eligible for Telework 
Travel: Up to 10% 
Regular/Temporary: Temporary 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Nonexempt 
Facility Location:
 
Job Location City: SILSBEE 
Job Location Address: 1215 E HWY 327 
Other Locations:
 
MOS Codes: No military equivalent 
Brief Job Description: 


This is a temporary position that is expected to end on 08/31/2027. Temporary employees may be eligible to transfer to a regular status vacant position, contingent upon regular status position availability, tenure, and job performance. 


Are you a highly motivated, compassionate and dedicated individual looking for a rewarding career assisting the most vulnerable citizens of Texas in need of food, medical care, cash assistance and other social services? 


If so, the Texas Health and Human Services Commission (HHSC) Access and Eligibility Services (AES) division is looking for individuals who want to join an exciting, dynamic team working in a high-performing and innovative environment. AES provides an integrated and streamlined approach to connect individuals to services and supports that: reduce institutionalization, allow individuals to remain in their communities, and promote economic and personal self-sufficiency. AES is built upon its&rsquo; core values of respect, ownership, collaboration, and integrity with a goal of delivering best-in-class customer service to clients and stakeholders. 

Our staff are well organized, able to multi-task, possess the ability to learn policy regulations, able to thrive in a challenging, fast-paced, and evolving environment, have good communication skills, a positive attitude, strong work-ethic and a desire to help others. If you also possess these skills, then we are looking for you.

We want you to join our team! 


The Eligibility Advisor I position consists of three job classifications; Eligibility Advisor, Medical Eligibility Specialist, and Hospital Based Worker that establish eligibility for different financial and medical programs. These include the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid for the Elderly and People with Disabilities (MEPD) and Medicaid. 


Essential Job Functions (EJFs): 


As an Eligibility Advisor I, you will receive paid, formal, training to perform the following essential job functions:
<ul>
<li>Interview applicants and recipients in person or by inbound or outbound telephone calls to obtain pertinent financial and personal information to determine financial eligibility for public assistance programs.</li>
<li>Evaluate data from various electronic and other sources to enter information into a computer-based eligibility system.</li>
<li>Compute and authorize benefits based on eligibility determination.
</li><li>Process work in accordance with state and federal regulations and established procedures, guidelines, and timeframes.</li>
<li>Perform other duties, as assigned.
</li></ul>Must be able to work overtime, as required by management, outside of normal hours of operation, which may include weekends when called upon.
Must be able to work in a highly stressful and fast-paced environment under constant pressure to meet required deadlines. 


Knowledge, Skills and Abilities (KSAs): 


In addition to the above listed functions, the following knowledge, skills, and abilities are needed:
<ul>
<li>Use fact-finding techniques to obtain, relate and evaluate information provided by applicants.</li>
<li>Read, understand, apply, and explain detailed regulations and policies.
</li><li>Perform basic arithmetic functions.</li>
<li>Manage time efficiently by establishing priorities in accordance with importance of deadlines.</li>
<li>Establish and maintain effective work relationships with others.
</li><li>Ability to communicate effectively both verbally and in writing.
</li><li>Follow written and oral directions and instructions.
</li><li>Operate computers to perform data entry and basic office software use such as Microsoft Word, Outlook, and Excel.</li>
</ul>
General knowledge and proficiency with computers and related technologies, such as software, hardware, operating systems, and typing skills.
Using Microsoft Teams and potentially soft phone technology is part of the everyday job expectations. 

Registrations, Licensure Requirements or Certifications: 


N/A 


Initial Screening Criteria: 


Applicants must meet the following education and experience requirements: 


Education:
High School Diploma or GED equivalent is required.
Sixty (60) semester or ninety (90) quarter hours from an accredited college or university is preferred. 

Experience:
One (1) year of customer service experience with public contact which can include retail, call center, clerical, hospitality, banking, receptionist, or similar customer service experience.
Thirty (30) semester or forty-five (45) quarter hours from an accredited college or university may be substituted for one (1) year of required experience. 


Experience in an environment interviewing clients and gathering personal information in-person or over the phone is preferred. 


Additional Information: 


Upon hire, the selected candidate will be required to sign a Temporary Employment Agreement. Temporary employees may be eligible to transfer to a regular status vacant position, contingent upon regular status position availability, tenure, and job performance. 


This posting may be used to fill positions in other locations within the region, as vacancies occur. 


Access and Eligibility Services Field Office normal hours of operation are Monday-Friday 8:00am to 5:00pm. Employees may be required to work overtime, as required by management, outside of normal hours of operation, which may include weekends. 

Applicants selected for hire will be required to pass a fingerprint criminal history background check. 


Applicants may not have a history of substantiated fraudulent activity against HHSC or any program it administers. Applicants who have a non-fraud overpayment with an outstanding balance must agree to repay the overpayment balance as a condition of employment. 

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC. 


Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor&rsquo;s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions. 


ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview. 


Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. 


HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs. 
</div></div></div></div> 
Nearest Major Market: Beaumont</div>

Neighborhood Healthcare

<div>Community health is about more than just vaccines and checkups. It&rsquo;s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We&rsquo;re with you every step of the way, with the care you need for each of life&rsquo;s chapters. At Neighborhood, we are Better Together.

Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a team of physicians, nurses, social workers, therapists and care coordinators to help them maintain good health and a good quality of life. Our goal is to keep our seniors happy and healthy at home surrounded by their family and community.

As a private, non-profit 501(C) (3) community health organization, we serve over 500k medical, dental, and behavioral health visits from more than 100,000 people annually. With two PACE centers located in Riverside County, our PACE program is positioned to serve over 650 senior participants.

The Eligibility Specialist will assist participants and potential participants in obtaining Medi-Cal and Medicare Coverage to access PACE services. This is a full-time, hybrid position(2 days/onsite &amp; 3 days/remote). Schedule: M-F, 8am-5pm.

Responsibilities
<ul>
<li>Assists individuals in applying for and retaining Medi-Cal and/or Medicare coverage, including collecting required information in a concise and accurate fashion</li>
<li>Assesses and discusses coverage options with potential enrollees and participants for the best solution to eligibility issues</li>
<li>Works with the potential enrollee or participant to submit applications in a timely manner in accordance with DHCS, County. and/or CMS expectations</li>
<li>Completes and submits enrollment and eligibility reporting in an accurate manner</li>
<li>Ensures prompt and proactive follow-ups on assigned eligibility cases</li>
<li>Works with PACE Social Services to remedy eligibility issues, as needed</li>
<li>Initiates and monitors health coverage redetermination/renewal processes for participants, including completing Medi-Cal renewal packages, reporting changes on active accounts, Medi-Cal add-ons, and referrals</li>
<li>Conducts in-services to educate and inform staff, participants, and their families of eligibility processes and updates</li>
<li>Assists with orientations and training of new staff</li>
<li>Accompanies participants to external facilities to address eligibility issues, such as County Offices, Social Security Office, Bank, etc., as needed</li>
<li>Complies with all department, organization, and government policies and procedures</li>
<li>Attends meetings and training courses, as required</li>
</ul>
Qualifications

Education/Experience
<ul>
<li>High school diploma or GED required</li>
<li>CA DHCS PACE and Medi-Cal Marketing certification required within 60 days of hire</li>
<li>One year of healthcare or customer service experience required</li>
<li>Valid CA driver&rsquo;s license and proof of auto insurance required</li>
<li>Current Basic Life Support (BLS) certification is required upon hire and must be maintained as a condition of employment. These courses must follow AHA guidelines, but may be completed through approved online providers such as ProMed or other equivalent programs that meet recognized BLS standards.</li>
</ul>
Additional Qualifications (Knowledge, Skills and Abilities)
<ul>
<li>Excellent verbal and written communication skills, including superior composition, typing, and proofreading skills</li>
<li>Excellent interpersonal skills with proven ability to cultivate and build positive relationships with internal departments and external stakeholders</li>
<li>Ability to interpret a variety of instructions in written, oral, diagram, or schedule form</li>
<li>Knowledge of and/or experience with HMO, Medi-Cal/Medicaid, Medicare, senior care related sales, and marketing</li>
<li>Excellent Microsoft Office applications and computer skills</li>
<li>Ability to successfully manage multiple tasks simultaneously.</li>
<li>Excellent planning and organizational ability</li>
<li>Excellent writing and presentation skills</li>
<li>Ability to think strategically and apply analytical skills</li>
<li>Ability to work as part of a team as well as independently</li>
<li>Ability to work with highly confidential information in a professional and ethical manner</li>
</ul>
Physical Requirements
<ul>
<li>Ability to lift/carry 10 lbs/weight</li>
<li>Ability to stand for long periods of time</li>
</ul>
Pay range: $27.21 to $38.09 per hour, depending on experience.
Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to: the candidate&rsquo;s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.</div>

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