Eligibility Worker

Overview

JOB TITLE: Eligibility Worker
DEPARTMENT: Social Services
STATUS: Full Time; 37.5 hrs/week;
Generally, Monday through Friday, 8:00 a.m.

- 4:30 p.m.

STARTING SALARY: The starting salary is $54,035 annually ($27.71/hr) based on the current pay grid. Receive anniversary step increases. In addition, receive annual cost-of-living adjustments (COLA) per the current Collective Bargaining Agreement.

FIRST REVIEWS/INTERVIEWS: The first review of applications will be on February 13, 2026. The first round of interviews will be held the week of February 16, 2026.

The Eligibility Worker, under general supervision, is responsible for performing a wide variety of tasks related to the determination of eligibility for income maintenance programs and services, establishing initial and ongoing eligibility for multiple programs; effectively communicating complex program requirements, and assisting program participants in understanding the criteria of each type of assistance. The role adapts to continuous policy updates, new system errors, legislative changes, and limited system functionality, supports program participants in achieving the highest degree of independence and addressing barriers to self-sufficiency;

provides education, enrollment, and assistance to managed health care enrollees, makes appropriate referrals to other community resources; and performs related work as assigned.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

The duties listed are illustrations of the work that may be performed. The omission of those specific statements does not exclude them from the position if the work is similar, related, or a logical assignment to the position.

• Interviews clients to determine potential eligibility for available programs and expedited services, obtain necessary factual information and verify information received.
• Provide information to educate individuals or groups about types of available programs, services, and resources to the public via telephone, mail, walk-ins, and presentations.
• Provide guidance on how to apply for programs, the application process, and necessary documentation.
• Assist clients with completing applications including utilizing the Language Line for interpretive services.
• Screen applications to determine which programs clients may potentially be eligible for based on their current needs. Request or forward applications and cases to other agencies if necessary.
• Provide specific program rules and eligibility criteria.
• Be knowledgeable of community resources to make appropriate client referrals.
• Refer clients to other programs of assistance in agency and community.
• Evaluate applications and verify the information for program eligibility and needed documentation.
• Determine and approve eligibility for accurate benefits based on client information and verifications following state and federal guidelines; applications must be processed within program timelines.
• Accurately enter case information into computer programs.
• Re-determine eligibility for benefits per program guidelines or depending on client’s change in income or status; suspend or close cases as necessary based on program eligibility.
• Evaluate and determine cost-effective health insurance payments and make updates to the computer program.
• Conduct continuous tracking of cases relating to client household changes, pending applications, retroactive coverage, time exemptions for certain programs, and any other factors which would affect eligibility for programs.
• Determine over payments for all programs if applicable and report possible fraud cases to Fraud Prevention Investigator.
• Complete ongoing training (online, unit meetings, conferences) and provide training to new EW staff.
• Perform peer case reviews to maintain the accuracy of cases.
• Assist law enforcement, fraud investigators, and the county attorney's office in the preliminary investigation, and preparing cases for prosecution.
• Prepare county cases for appeal hearings and participate in appeal hearings or provide testimony in court as needed.
• Provide input to assist Supervisors in developing procedures for program areas that are left to the discretion of the county…