Medicaid Eligibility Specialist- Denver Human Services Job Vacancy in City and County of Denver Denver, CO – Latest Jobs in Denver, CO

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Company Name : City and County of Denver
Location : Denver, CO
Position : Medicaid Eligibility Specialist- Denver Human Services

Job Description : About Our Job

This posting will accept applications through March 31st. Please apply as soon as possible.

Diversity in the City
The City and County of Denver is committed to cultivating a culture of equity, diversity, and inclusion. This commitment is woven into our values and belief that we are strongest when we embrace and celebrate our differences. We aim to have employees who are as diverse as our residents, with different perspectives and unique ways of thinking. If you share these values and our enthusiasm for equity, we encourage you to apply to join our team.

About Denver Human Services
Denver Human Services provides support to one in three Denver residents. We envision a healthy community where people are connected, supported, safe, and well. Our services include food, cash and medical benefits, child support and veteran services, child welfare and adult protection, work opportunities, and more. If you are committed to supporting the health and strength of the community and want to be a part of an engaged workplace, we’d love to work with you!

Assistance Divisions
The dedicated staff at Denver Human Services (DHS) are here to listen and advise, helping people apply for public assistance programs. We can provide information about food assistance and financial assistance, as well as help for veterans and those who need long term care. DHS provides a range of other services, including help with transitional housing, medical assistance, and heating costs.

Denver Human Services is seeking a passionate and dedicated individual to serve as the Eligibility Specialist for the Medical Assistance – Medicaid Team in the Family and Adult Assistant Division.

In this role, you will be responsible for working Exception Reports and reports generated from internal/external interfaces and platforms; researching difficult cases and potential Help Desk Tickets; researching claims; assisting Eligibility Technicians with Medical Assistance tasking; providing over the shoulder support to Eligibility Technicians and identifying and tracking error trends.

The City and County of Denver utilizes a hybrid model workplace that balances the responsibilities of public service with the benefits of a flexible work environment. Employees work where needed, at a city site and/or in the field at least two days a week, and telecommute remotely at a designated workplace within the State of Colorado the remaining days. In this role you will be reporting to the following Denver Human Services location: 3815 Steele St., Denver, CO 80205.

The Eligibility Specialist essential duties include but are not limited to:

Assists clients in the Medical Assistance – Medicaid Programs and determines appropriate services/programs to meet the needs of clients by conducting eligibility interviews, researching and evaluating all necessary information such as family members and relationships, financial status and income resources. Reviews and interprets legal documents provided by clients such as court documents/orders, property transactions, trusts, annuities, life insurance policies, financial transactions, and transfers of resources in order to determine eligibility for public assistance programs. Act as an eligibility determination subject matter expert for the total array of programs and services available to clients and serves as a resource to eligibility staff by assisting staff with difficult/complex cases, formulating approaches to address issues/problems through reporting techniques, and briefing supervisors/managers on recurring concerns and issues found through qualitative and quantitative means.

Elicits and verifies pertinent eligibility information such as employment, income, residence, property ownership, rent, household expenses, and other banking and financial resources, assists applicants to obtain additional information and resolve discrepancies, and answers applicant questions regarding eligibility. Serves as a community resource specialist for clients and refers clients to internal and/or external services and services providers. Reviews cases in the Colorado Benefits Management System (CBMS) and researches all associated discrepancies. Works reports received from internal and external platforms and systems to determine timeliness and workload capacity.

The Eligibility Specialist will also:

Determine initial and on-going eligibility for public assistance programs in accordance with federal and state laws, county rules and regulations, and approves and issues benefits
Review all necessary documents, systems, case comments, and case history to determine validity of discrepancy
Record client information enters and updates information into complex state and county computer systems and responds to inquiries about client records for administrative state hearings, federal reviews, fraud investigations, and federal and state program management and evaluation
Complete and mail communication to Client, Content Management and Accounts Receivable
Ensure benefit calculations made by the state computer system are accurate to reduce/eliminate errors. Impact of financial errors is significant due to state and federal sanctions
Report daily work progress to Supervisor
Explain rights and responsibilities to clients and provides referrals to non-profit agencies and other service providers to facilitate a comprehensive solution to the client’s issues
Monitor changes in client’s status, contacts clients to verify changes, and makes appropriate adjustments to eligibility and support payments
Monitor changes in the Colorado Benefits Management System (CBMS), maintains current knowledge of CBMS, programs, policies, and community resources and adjusts work processes to ensure accurate provision of benefits
Perform other related duties as assigned

About You

Our ideal candidate will have:

Understanding of leadership and embrace change, and have a prove track-record of success
Be able to work independently with minimal supervision
Be comfortable troubleshooting cases and navigating through CBMS
Possess top-notch problem-solving skills and be proficient with system interfaces
Green Belt Certification through Denver Human Services or an approved Lean Six Sigma Program
Show understanding, courtesy, tact, empathy, and concern
Develop and maintain working relationships while encouraging cooperation, pride, and a commitment to teamwork
Be sensitive to cultural diversity, race, gender, and other individual differences in the workforce
Be willing to go the extra mile for our clients and encompass a #behuman mentality
Demonstrated proficiency with Medicaid, Long Term Care, Food Assistance and Adult Financial eligibility determination

We realize your time is valuable so please do not apply if you do not have at least the following required minimum qualifications:

Education: Graduation from high school or the possession of a GED, HiSET or TASC Certificate
Experience: Four (4) years of experience determining eligibility for a variety of public assistance programs
Education & Experience Equivalency: Additional appropriate education may be substituted for the minimum experience requirements

About Everything Else

Job Profile CA2666 Eligibility Specialist

Position Type Unlimited

Position Salary Range $21.70 – $32.55

Starting Pay Although our full pay range is listed above, the budgeted hiring range for this position will most likely be between $21.70 – $27.13 per hour.

Agency Denver Human Services

The City and County of Denver provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, national origin, disability, genetic information, age, or any other status protected under federal, state, and/or local law.

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