DSHS ESA Public Benefits Specialist

DSHS ESA – Public Benefits Specialist 4, Lead Worker Specialized Medical Unit

Elevate your career in a lead role that truly makes a difference! The Economic Services Administration (ESA), Community Services Division, has an opportunity as a Public Benefit Specialist 4 (PBS4) to join our team at our Customer Service Contact Centers, Specialized Medical Unit. As a Lead worker, you're expected to possess a high level of proficiency in all public benefit programs, especially, all Medical programs.

Responsible to audit, coach, train and guide lower-level Public Benefits Specialists. This position will have access to the Washington Health Plan Finder (HPF) system and personally identifiable information (PII). Per the Information Exchange Agreement No. 2013-02 between the Centers for Medicare & Medicaid Services (CMS) and State-Based Exchanges for the disclosure of health insurance affordability programs information under the Patient Protection and Affordable Care Act, passing a criminal background check is required for this position.

If you are an experienced professional ready to lead, mentor, and ensure the quality of public assistance services, this role offers the opportunity to make a lasting impact within the Community Services Division.

See why people like you chose careers with DSHS:

• Assigns work to Public Benefits Specialist staff who process cash, medical, and/or food benefits.
• Audits/reviews 100% of all cases that have met their Spenddown prior to approval. Conducts ongoing audits for new and experienced staff. Establishes reports and recommendations to supervisor on staff progress.
• Performs more complex duties in relation to establishing financial eligibility, rule interpretation, planning, and procedural development.
• Reviews cases and independently analyzes case actions for accuracy. Contacts staff, agencies and the community as necessary for clarifying information.
• Uses basic understanding of the administrative hearing process to review cases and to help decide if a hearing request can be settled prior to submission and assures appropriate action is taken.
• Assists customers with the process of applying for Apple Healthcare by entering information into the Health Plan Finder (HPF) system on behalf of the clients.
• Investigates and resolves customer complaints. Reviews and coordinates resolution of case errors. Identifies and reports performance gaps. Works independently or with others to identify and carry out creative solutions to performance issues.
• Obtain and review necessary data, documentation and verification for Federal or State assistance as it relates to the individual's specific circumstance.

What we're looking for:

• Knowledgeable in Medical Eligibility as well as the Spenddown program and knowledge of Washington Administrative Code (WAC), policies, and procedures used to determine eligibility for Community Services Division programs.
• Proficiency using computer systems and applications to process cases, research information, and make accurate eligibility decisions.
• Ability to analyze and interpret complex data from multiple sources to ensure accurate and timely case actions.
• Strong interpersonal and customer service skills, with the ability to interact professionally and respectfully with clients, coworkers, and community partners.
• Ability to independently prioritize and manage a high-volume workload while meeting established deadlines.
• Resilience and professionalism when working in high-pressure situations and handling challenging customer interactions.
• Flexibility to adapt to changing priorities and effectively manage multiple assignments in a fast-paced environment while meeting performance expectations.

Who should apply?

• Professionals with 12 months of experience as a Public Benefits Specialist 3.
• OR a Bachelor's degree or higher AND twelve months of experience as a Public Benefits Specialist 2 determining eligibility for public assistance or long-term care services.
• OR 5 years of combined higher education and/or equivalent experience may substitute for degree and PBS work experience requirements. Total must include at least one year's equivalent work experience. Examples of equivalent experience include but are not limited to:
• Providing eligibility for services or direct customer service serving historically marginalized communities
• Experience examining/processing loan applications
• Medical insurance or rehabilitation claims
• Unemployment insurance claims
• Providing staff support in financial eligibility determination, or in a job analyzing, verifying, and evaluating financial data and information
• AND satisfactory completion of the agency's Public Benefits Specialist Training Program.

Interested? Along with your application, please include:

• An updated resume
• Three professional references with contact information

Questions? Please reach out to DSHS Recruiter Alex Baclaan laan.gov and reference job number #05419.