Eligibility Specialist II; Non-MAGI

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.

This position is located in Localized Eligibility Processing (LEP), Fairfield County.

This is an in‑office role and not a telecommute or remote position.

• Uses various information sources, electronic tools, and systems to collect, assemble, evaluate, and act upon information provided by applicants, 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 gathers additional information for beneficiaries as necessary with the least burden to the applicant/beneficiary possible.
  
  Performs follow‑up activities efficiently, using the most appropriate communication method to obtain outstanding information and documents all notes and steps clearly for review and hand‑off to other specialists.
• Demonstrates proficiency in utilizing all processes, policies, procedures, and system updates to ensure determinations, reviews, and changes are completed accurately with satisfactory documentation. Makes accurate determinations of eligibility based on the Department’s rules and standards; resolves discrepancies in a timely manner and follows appropriate escalation processes. Labels all documentation, records decisions and notes accurately in the appropriate record‑keeping system.
• Maintains a professional demeanor and communication style, ensuring that interactions with co‑workers, supervisors, and beneficiaries are clear, polite, and concise. Participates in customer‑service and privacy training and ensures confidential or private information is maintained in accordance with State and Federal law.
• Attends all mandatory meetings, trainings, and events as directed. Maintains awareness of and compliance with all agency policies, including privacy, confidentiality, performance, leave, and compensation. Maintains appropriate certifications for emergency management duties as necessary and performs other duties as assigned by supervisory staff.

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

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.

• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: 20 lbs.
• In‑office role.

• Familiarity with computers, standard Microsoft Office software, internet browsers, and the ability to read, write, and speak English clearly and concisely.
• Basic mathematical computation skills.
• Professional office environment customer‑service skills, including face‑to‑face, telephonic, or written communication.
• Ability to learn, retain, and apply federal rules and standards for processing Medicaid eligibility determinations.
• Maintain productive work spaces and perform tasks effectively to ensure completeness, accuracy, and timeliness of eligibility determinations.

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), national origin, age (40 or older), disability or genetic information.